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1952743155
MICHELLE L SULLIVAN
EVERETT, WA
NPI
1952743155
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Former Name
MICHELLE L LUCENA
Entity Type
Individual
Gender
Female
Sole Proprietor ?
Yes
Primary Taxonomy
225700000X Massage Therapist
(Licence: WA MA60394974)
Enumeration Date
2013-07-29
Last Update Date
2013-07-29
Business Address
Mrs. MICHELLE L SULLIVAN LMP
4322 RUCKER AVE
EVERETT, WA 98203-2233
Phone number: 425-258-5454
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Mailing Address
Mrs. MICHELLE L SULLIVAN LMP
PO BOX 5
LAKE STEVENS, WA 98258-0005
Phone number: 425-299-9745
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EVERETT THERAPEUTIC CENTER, LLC