=====================================================
General NPI Number Information
=====================================================
NPI Number | 1710344189
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | FELICIA A CURTIS
-----------------------------------------------------
Gender | Female
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 01/15/2016
-----------------------------------------------------
Last Update Date | 01/15/2016
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 8033 W GRANDRIDGE BLVD STE C
-----------------------------------------------------
City | KENNEWICK
-----------------------------------------------------
State | WA
-----------------------------------------------------
Zip | 99336-7159
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 509-783-1899
-----------------------------------------------------
Fax | 509-783-1898
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 8033 W GRANDRIDGE BLVD STE C
-----------------------------------------------------
City | KENNEWICK
-----------------------------------------------------
State | WA
-----------------------------------------------------
Zip | 99336-7159
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 509-783-1899
-----------------------------------------------------
Fax | 509-783-1898
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 225700000X
-----------------------------------------------------
Taxonomy Name | Massage Therapist
-----------------------------------------------------
License Number | MA60606379
-----------------------------------------------------
License Number State | WA
-----------------------------------------------------