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1295855138
DOUGLAS LEE BLACK
VANCOUVER, WA
NPI
1295855138
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
Yes
Primary Taxonomy
225700000X Massage Therapist
(Licence: WA MA00011374)
Enumeration Date
2007-03-31
Last Update Date
2022-07-21
Business Address
-- DOUGLAS LEE BLACK LMP
16906 SE 1ST ST STE 103
VANCOUVER, WA 98684-8512
Phone number: 360-903-9963
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Mailing Address
-- DOUGLAS LEE BLACK LMP
6700 NE 162ND AVE STE 611
VANCOUVER, WA 98682-3899
Phone number: 360-903-9963
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