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General NPI Number Information
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NPI Number | 1710466123
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Entity Type | Individual
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Provider Name | ALETHA L LASSITER BS, LMT, RYT 200
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Gender | Female
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Dates
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Enumeration Date | 08/08/2018
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Last Update Date | 08/08/2018
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Provider Practice Location Address
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Address Line | 246 E MAIN ST
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City | PULLMAN
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State | WA
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Zip | 99163-2619
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Country | US
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Telephone | 208-310-1279
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Fax |
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Provider Business Mailing Address
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Address Line | 1155 SE PRO MALL BLVD TRLR 314
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City | PULLMAN
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State | WA
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Zip | 99163-5434
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Country | US
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Telephone | 208-310-1279
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Fax |
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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 | MAS-3485
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License Number State | ID
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Taxonomy #2
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Taxonomy Code | 225700000X
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Taxonomy Name | Massage Therapist
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License Number | 60847751
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License Number State | WA
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