Healthcare Provider Details

I. General information

NPI: 1275939449
Provider Name (Legal Business Name): DAPHNE S. CONNER L.M.P.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/14/2014
Last Update Date: 11/14/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

14326 GREENWOOD AVE N DAPHNE CONNER ESSENTIAL CARE MASSAGE
SEATTLE WA
98133-6813
US

IV. Provider business mailing address

14326 GREENWOOD AVE N DAPHNE CONNER - ESSENTIAL CARE MASSAGE
SEATTLE WA
98133-6813
US

V. Phone/Fax

Practice location:
  • Phone: 206-440-8702
  • Fax: 206-440-2661
Mailing address:
  • Phone: 206-440-8702
  • Fax: 206-440-2661

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225700000X
TaxonomyMassage Therapist
License NumberWA00012418
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: