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1376200410
LACY JUANELLA WAGNER
YAKIMA, WA
NPI
1376200410
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
225700000X Massage Therapist
(Licence: WA MA61205126)
Enumeration Date
2021-11-23
Last Update Date
2021-11-23
Business Address
LACY JUANELLA WAGNER Massage therapist
3908 CREEKSIDE LOOP STE 110
YAKIMA, WA 98902-4858
Phone number: 509-571-1081
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Mailing Address
LACY JUANELLA WAGNER Massage therapist
808 W ORCHARD AVE
SELAH, WA 98942-1266
Phone number: 509-949-2916
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