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General NPI Number Information
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NPI Number | 1780881631
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Entity Type | Individual
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Provider Name | SAMANTHA APPLE LMP
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Gender | Female
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Dates
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Enumeration Date | 07/02/2007
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Last Update Date | 02/08/2011
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Provider Practice Location Address
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Address Line | 13025 NE FOURTH PLAIN BLVD SUITE 102
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City | VANCOUVER
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State | WA
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Zip | 98682-5651
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Country | US
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Telephone | 360-253-4285
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Fax | 503-253-9469
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Provider Business Mailing Address
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Address Line | 21525 NE 68TH ST
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City | VANCOUVER
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State | WA
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Zip | 98682-9098
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Country | US
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Telephone | 360-606-9270
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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 | MA00022188
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License Number State | WA
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