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General NPI Number Information
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NPI Number | 1881077303
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Entity Type | Individual
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Provider Name | YVETTE MARIE BANKS LMP
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Gender | Female
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Dates
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Enumeration Date | 07/01/2015
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Last Update Date | 08/28/2024
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Provider Practice Location Address
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Address Line | 516 SE CHKALOV DR STE 49
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City | VANCOUVER
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State | WA
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Zip | 98683-5277
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Country | US
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Telephone | 360-869-6551
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Fax | 503-564-1953
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Provider Business Mailing Address
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Address Line | 4619 NE 112TH AVE APT D202
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City | VANCOUVER
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State | WA
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Zip | 98682-5403
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Country | US
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Telephone | 360-869-6551
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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 | MA60417281
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License Number State | WA
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