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General NPI Number Information
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NPI Number | 1003219023
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Entity Type | Individual
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Provider Name | SABRINA BIANCA KRENZELOK LMP
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Gender | Female
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Dates
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Enumeration Date | 10/04/2014
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Last Update Date | 10/04/2014
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Provider Practice Location Address
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Address Line | 3887 NW ANDERSON HILL RD
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City | SILVERDALE
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State | WA
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Zip | 98383-7811
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Country | US
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Telephone | 360-516-6804
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Fax |
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Provider Business Mailing Address
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Address Line | 34410 BRIDGE VIEW DR NE
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City | KINGSTON
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State | WA
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Zip | 98346-9751
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Country | US
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Telephone | 360-908-0821
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 225700000X
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Taxonomy Name | Massage Therapist
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License Number | MA 60487438
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License Number State | WA
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