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1508408303
STACEY S VANWAVEREN
MOUNT VERNON, WA
NPI
1508408303
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
Yes
Primary Taxonomy
225700000X Massage Therapist
(Licence: WA MA60973308)
Enumeration Date
2019-10-13
Last Update Date
2019-10-13
Business Address
STACEY S VANWAVEREN LMT
403 MYRTLE ST
MOUNT VERNON, WA 98273-3849
Phone number: 360-941-9545
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Mailing Address
STACEY S VANWAVEREN LMT
3729 SWAN CT
MOUNT VERNON, WA 98273-8578
Phone number: 360-941-9545
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