MEDICARE: MIEJA WATSON

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	225700000X	Massage Therapist	20254223	WV

General Provider Information

NPI Number	:	1083577084
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MIEJA WATSON

Provider Business Mailing Address
First Line	:	3900 EMERSON AVE
Second Line	:
City	:	PARKERSBURG
State	:	WV
Zip	:	26104-1115
Country	:	US
Telephone Number	:	304-444-7786
Fax Number	:

Provider Business Practice Location Address
First Line	:	3900 EMERSON AVE
Second Line	:
City	:	PARKERSBURG
State	:	WV
Zip	:	26104-1115
Country	:	US
Telephone Number	:	304-444-7786
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	12/05/2025
Last Update Date	:	12/05/2025

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Directions to “ MIEJA WATSON ” Practice Location

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