Individual
ELISE LORRAINE DECKARD
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LMP
Contact information
Practice address
10125 MAIN PL, SUITE A, BOTHELL, WA 98011-3457
(425) 806-5525
Mailing address
10125 MAIN PL, SUITE A, BOTHELL, WA 98011-3457
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
MA00024104
WA
Other
Enumeration date
08/17/2007
Last updated
07/09/2009
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