MEDICARE: MISS ANNA KAY TABER

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	MA 60127469	WA

General Provider Information

NPI Number	:	1316260706
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MISS ANNA KAY TABER

Provider Business Mailing Address
First Line	:	PO BOX 163
Second Line	:
City	:	NEWMAN LAKE
State	:	WA
Zip	:	99025-0163
Country	:	US
Telephone Number	:	509-540-9856
Fax Number	:

Provider Business Practice Location Address
First Line	:	101 E HASTINGS RD
Second Line	:
City	:	SPOKANE
State	:	WA
Zip	:	99218-4901
Country	:	US
Telephone Number	:	509-340-3303
Fax Number	:

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

Provider Enumeration Date	:	03/12/2010
Last Update Date	:	03/12/2010

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Directions to “ MISS ANNA KAY TABER ” Practice Location

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