Individual
CARLY BUTKOVICH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
8621 N DIVISION ST STE A, SPOKANE, WA 99208-5943
(509) 468-5247
(509) 319-2477
Mailing address
8621 N DIVISION ST STE A, SPOKANE, WA 99208-5943
(509) 468-5247
(509) 319-2477
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
MA60467577
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
MA60467577
WA STATE DEPT OF HEALTH
WA
Enumeration date
08/07/2014
Last updated
10/26/2016
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