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General NPI Number Information
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NPI Number | 1003234733
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Entity Type | Individual
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Provider Name | KISHA HANLEY LMP
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Gender | Female
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Dates
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Enumeration Date | 03/31/2014
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Last Update Date | 10/09/2020
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Provider Practice Location Address
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Address Line | 5219 W CLEARWATER AVE STE 1
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City | KENNEWICK
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State | WA
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Zip | 99336-1914
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Country | US
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Telephone | 509-440-2808
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Fax |
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Provider Business Mailing Address
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Address Line | 1839 PEACHTREE LN APT 4
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City | RICHLAND
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State | WA
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Zip | 99352-8485
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Country | US
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Telephone | 509-440-2808
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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 | 60422398
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License Number State | WA
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