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General NPI Number Information
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NPI Number | 1316728322
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Entity Type | Individual
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Provider Name | ANA K AGUIRRE MONDAY MASSAGE THERAPIST
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Gender | Female
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Dates
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Enumeration Date | 10/06/2023
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Last Update Date | 10/06/2023
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Provider Practice Location Address
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Address Line | 25 S 7TH AVE
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City | OTHELLO
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State | WA
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Zip | 99344-1401
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Country | US
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Telephone | 509-770-4067
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 336
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City | OTHELLO
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State | WA
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Zip | 99344-0336
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Country | US
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Telephone | 509-331-6404
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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 | 61228299
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License Number State | WA
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