Individual
AMANDA SUSANNA WILLMS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
L.M.P.
Contact information
Practice address
3400 W CLEARWATER AVE, SUITE 5, KENNEWICK, WA 99336-2709
(509) 737-0610
Mailing address
209 S VANCOUVER ST, KENNEWICK, WA 99336-3221
(509) 591-7088
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
MA60297070
WA
Other
Enumeration date
08/10/2012
Last updated
08/10/2012
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