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General NPI Number Information
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NPI Number | 1730398207
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Entity Type | Individual
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Provider Name | ANNE ILSLEY SELLERY LMP
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Gender | Female
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Dates
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Enumeration Date | 05/22/2007
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 3320 W MCGRAW ST UNRAVEL THERAPEUTICS
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City | SEATTLE
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State | WA
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Zip | 98199
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Country | US
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Telephone | 206-283-9910
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Fax | 206-283-9935
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Provider Business Mailing Address
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Address Line | 7012 5TH AVE NE
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City | SEATTLE
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State | WA
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Zip | 98115
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Country | US
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Telephone | 646-641-6060
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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 | MA00023842
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License Number State | WA
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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 | 51934406
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License Number State |
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