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General NPI Number Information
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NPI Number | 1578768719
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Entity Type | Individual
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Provider Name | JULIE KAY CLOUGH THOMPSON L.M.P.
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Gender | Female
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Dates
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Enumeration Date | 06/18/2007
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 298 S MAIN ST SUITE 201
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City | COLVILLE
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State | WA
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Zip | 99114-2447
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Country | US
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Telephone | 509-685-0998
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Fax | 509-684-8685
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Provider Business Mailing Address
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Address Line | 298 S MAIN ST SUITE 201
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City | COLVILLE
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State | WA
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Zip | 99114-2447
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Country | US
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Telephone | 509-685-0998
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Fax | 509-684-8685
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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 | 024201MA00014278
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License Number State | WA
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