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General NPI Number Information
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NPI Number | 1730390402
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Entity Type | Individual
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Provider Name | TERRACE WASHINGTON LMT, CMT
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Gender | Female
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Dates
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Enumeration Date | 05/24/2007
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Last Update Date | 05/03/2012
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Provider Practice Location Address
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Address Line | 900 PRINCE ST
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City | ALEXANDRIA
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State | VA
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Zip | 22314-3009
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Country | US
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Telephone | 703-683-7771
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Fax | 703-683-8777
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Provider Business Mailing Address
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Address Line | 6404 CHATHAM PARK DR
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City | BRANDYWINE
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State | MD
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Zip | 20613-5640
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Country | US
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Telephone | 954-290-9695
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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 | 0019009438
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License Number State | VA
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