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General NPI Number Information
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NPI Number | 1972655181
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Entity Type | Individual
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Provider Name | SUSAN ALICE MAYS LMP
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Gender | Female
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Dates
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Enumeration Date | 01/17/2007
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 4608 NE 4TH ST
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City | RENTON
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State | WA
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Zip | 98059-5004
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Country | US
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Telephone | 425-226-6261
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Fax | 425-917-5325
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Provider Business Mailing Address
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Address Line | 15818 SE 175TH PL
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City | RENTON
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State | WA
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Zip | 98058-9122
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Country | US
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Telephone | 425-260-3707
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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 | MA00020669
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License Number State | WA
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