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General NPI Number Information
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NPI Number | 1427247857
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Entity Type | Individual
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Provider Name | BERNADETTE M. TAISEY LMP
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Gender | Female
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Dates
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Enumeration Date | 10/22/2007
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Last Update Date | 10/22/2007
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Provider Practice Location Address
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Address Line | 635 S.W. 154TH STREET
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City | BURIEN
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State | WA
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Zip | 98166-0174
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Country | US
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Telephone | 206-246-8355
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Fax | 206-244-7799
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Provider Business Mailing Address
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Address Line | PO BOX 66174
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City | BURIEN
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State | WA
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Zip | 98166-0174
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Country | US
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Telephone | 206-246-8355
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Fax | 206-244-7799
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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 | MA00004112
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License Number State | WA
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