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General NPI Number Information
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NPI Number | 1487841623
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Entity Type | Individual
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Provider Name | LETA KAYE EILERS MA00024665
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Gender | Female
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Dates
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Enumeration Date | 10/02/2007
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Last Update Date | 09/11/2012
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Provider Practice Location Address
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Address Line | 17039 SE 272ND ST SUITE 104
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City | COVINGTON
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State | WA
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Zip | 98042-7348
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Country | US
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Telephone | 253-740-8373
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Fax | 253-631-7920
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Provider Business Mailing Address
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Address Line | 16431 SE 235TH ST.
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City | KENT
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State | WA
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Zip | 98042
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Country | US
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Telephone | 253-740-8373
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Fax | 253-631-7920
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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 | MA00024665
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License Number State | WA
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