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General NPI Number Information
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NPI Number | 1912065459
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Entity Type | Individual
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Provider Name | CATHERINE MANN LMT,LMP, NCBTMB
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Gender | Female
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Dates
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Enumeration Date | 12/05/2006
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 1412 NE 134TH ST #260
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City | VANCOUVER
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State | WA
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Zip | 98685-2719
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Country | US
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Telephone | 360-574-3668
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Fax |
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Provider Business Mailing Address
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Address Line | 404 NE 73RD AVE
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City | PORTLAND
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State | OR
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Zip | 97213-6308
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Country | US
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Telephone | 503-347-3591
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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 | 19224
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License Number State | WA
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