Individual
DIVA KAINOA NELSON BROWN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LMP
Contact information
Practice address
2146 W RAILROAD AVE, SHELTON, WA 98584-7126
(360) 790-4365
Mailing address
1139 W FRANKLIN ST, SHELTON, WA 98584
(360) 790-4365
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
00023577
WA
Other
Enumeration date
10/28/2008
Last updated
09/09/2016
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