Individual
GEORGE SAMRA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
L.M.P.
Contact information
Practice address
15614 1ST AVE S, BURIEN, WA 98148-1209
(206) 248-8976
(206) 248-8976
Mailing address
15614 1ST AVE S, BURIEN, WA 98148-1209
(206) 248-8976
(206) 248-8976
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
MA00011379
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
123618
L&I PROVIDER NUMBER
WA
01
—
MA00011379
MASSAGE LICENSE
WA
Enumeration date
04/23/2007
Last updated
07/08/2007
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