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General NPI Number Information
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NPI Number | 1952635476
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Entity Type | Individual
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Provider Name | NATASHA LEANN KEELEY LMP
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Gender | Female
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Dates
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Enumeration Date | 09/30/2009
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Last Update Date | 09/30/2009
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Provider Practice Location Address
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Address Line | 111 AVENUE C STE 103
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City | SNOHOMISH
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State | WA
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Zip | 98290-2766
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Country | US
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Telephone | 360-862-9808
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Fax |
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Provider Business Mailing Address
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Address Line | 7920 WOODS LAKE RD
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City | MONROE
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State | WA
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Zip | 98272-9053
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Country | US
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Telephone | 425-327-1547
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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 | MA60103764
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License Number State | WA
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