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General NPI Number Information
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NPI Number | 1609346758
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Entity Type | Individual
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Provider Name | SARAH RACHEL MCCULLOUGH MA60135663
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Gender | Female
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Dates
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Enumeration Date | 12/03/2018
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Last Update Date | 12/03/2018
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Provider Practice Location Address
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Address Line | 3700 MARTIN WAY E STE 108
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City | OLYMPIA
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State | WA
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Zip | 98506-5052
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Country | US
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Telephone | 360-561-0171
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Fax | 360-915-7857
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Provider Business Mailing Address
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Address Line | 3535 MARTIN WAY E
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City | OLYMPIA
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State | WA
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Zip | 98506-5052
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Country | US
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Telephone | 360-491-9135
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Fax | 360-923-9382
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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 | MA60135663
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License Number State | WA
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