| NPI | 1972959112 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KELSEY M WEILAND Massage Therapist 360-742-4328 |
| Organization Subpart ? | No |
| Primary Taxonomy | 302F00000X Exclusive Provider Organization (Licence: WA MA60096383) |
| Enumeration Date | 2016-05-06 |
| Last Update Date | 2016-05-06 |