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General NPI Number Information
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NPI Number | 1336695816
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Entity Type | Individual
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Provider Name | MARY F RODGERS
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Gender | Female
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Dates
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Enumeration Date | 08/25/2016
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Last Update Date | 09/26/2022
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Provider Practice Location Address
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Address Line | 423 3RD AVE W
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City | SEATTLE
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State | WA
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Zip | 98119-4001
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Country | US
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Telephone | 206-679-0111
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Fax |
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Provider Business Mailing Address
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Address Line | 24 ROY ST # 231
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City | SEATTLE
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State | WA
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Zip | 98109-4018
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Country | US
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Telephone | 561-633-9861
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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 60629013
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License Number State | WA
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