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NPI 1790416170

NPI 1790416170 : NATALIYA ZAGORODNYAYA LMT : CHEHALIS, WA

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General NPI Number Information
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    NPI Number           |    1790416170
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    Entity Type          |    Individual 
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    Provider Name        |    NATALIYA ZAGORODNYAYA LMT
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    Gender               |    Female 
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Dates
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    Enumeration Date     |    06/17/2022
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    Last Update Date     |    06/17/2022
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Provider Practice Location Address
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    Address Line         |    381 S MARKET BLVD 
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    City                 |    CHEHALIS
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    State                |    WA
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    Zip                  |    98532-3041
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    Country              |    US
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    Telephone            |    541-852-9770
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    Fax                  |    
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Provider Business Mailing Address
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    Address Line         |    381 S MARKET BLVD 
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    City                 |    CHEHALIS
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    State                |    WA
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    Zip                  |    98532-3041
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    Country              |    US
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    Telephone            |    254-202-5210
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    Fax                  |    360-242-2795
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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       |    MA61220860
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    License Number State |    WA
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