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Individual

BRANDON BOUTAIN

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man

Contact information

Practice address
12121 E BROADWAY AVE STE 5B, SPOKANE VALLEY, WA 99206-4972
(509) 921-9800
(509) 921-9810
Mailing address
12121 E BROADWAY AVE STE 5B, SPOKANE VALLEY, WA 99206-4972
(509) 921-9800
(509) 921-9800

Taxonomy

Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
MA61007858
WA

Other

Enumeration date
11/02/2019
Last updated
11/02/2019
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