Healthcare Provider Details
I. General information
NPI: 1477952232
Provider Name (Legal Business Name): GRETCHEN SCHUETTER LMP
Entity Type: Individual
Gender: Female
Sole Proprietor: N
II. Dates (important events)
Enumeration Date: 08/18/2014
Last Update Date: 08/18/2014
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
4220 132ND ST SE STE 101
MILL CREEK WA
98012-8999
US
IV. Provider business mailing address
111 MARKET ST NE STE 108
OLYMPIA WA
98501-1008
US
V. Phone/Fax
- Phone: 425-316-8046
- Fax: 425-338-9637
- Phone: 360-754-7085
- Fax: 360-754-3671
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 225700000X |
| Taxonomy | Massage Therapist |
| License Number | MA60042218 |
| License Number State | WA |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: