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General NPI Number Information
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NPI Number | 1013446483
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Entity Type | Individual
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Provider Name | IMANI JOY PYATT
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Gender | Female
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Dates
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Enumeration Date | 06/08/2017
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Last Update Date | 06/08/2017
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Provider Practice Location Address
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Address Line | 2920 1ST AVE S
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City | SEATTLE
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State | WA
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Zip | 98134-1820
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Country | US
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Telephone | 206-682-0676
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Fax | 206-623-0397
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Provider Business Mailing Address
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Address Line | 1026 ABBOTT DR
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City | PEARLAND
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State | TX
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Zip | 77584-2390
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Country | US
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Telephone |
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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 | MA60730245
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License Number State | WA
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