Healthcare Provider Details

I. General information

NPI: 1770891707
Provider Name (Legal Business Name): SERRA LYNNE SCHLOSSER L.M.P.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/24/2010
Last Update Date: 09/24/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3209 E. 57TH AVENUE
SPOKANE WA
99223
US

IV. Provider business mailing address

3209 E. 57TH AVENUE
SPOKANE WA
99223
US

V. Phone/Fax

Practice location:
  • Phone: 509-448-9398
  • Fax: 509-232-5550
Mailing address:
  • Phone: 509-448-9398
  • Fax: 509-232-5550

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225700000X
TaxonomyMassage Therapist
License NumberMA60166077
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: