MEDICARE: AIMEE NASSOIY L.M.P.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	225700000X	Massage Therapist	MA00001111	WA

General Provider Information

NPI Number	:	1114938347
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	AIMEE NASSOIY L.M.P.

Provider Business Mailing Address
First Line	:	214 FARM RD
Second Line	:
City	:	LOPEZ ISLAND
State	:	WA
Zip	:	98261-8243
Country	:	US
Telephone Number	:	360-468-2493
Fax Number	:

Provider Business Practice Location Address
First Line	:	33 WEEKS RD.LOPEZ MASSAGEWORKS
Second Line	:	LOPEZ PLAZA BUILDING
City	:	LOPEZ ISLAND
State	:	WA
Zip	:	98261
Country	:	US
Telephone Number	:	360-468-3239
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/11/2006
Last Update Date	:	07/08/2007

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