MEDICARE: MICHELLE R AGLIANO LMP

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	00003605	WA

General Provider Information

NPI Number	:	1235201310
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MICHELLE R AGLIANO LMP

Provider Business Mailing Address
First Line	:	PO BOX 683
Second Line	:
City	:	SOAP LAKE
State	:	WA
Zip	:	98851-0683
Country	:	US
Telephone Number	:	509-594-0807
Fax Number	:

Provider Business Practice Location Address
First Line	:	37 HEMLOCK ST N # 683
Second Line	:
City	:	SOAP LAKE
State	:	WA
Zip	:	98851-9108
Country	:	US
Telephone Number	:	509-594-0807
Fax Number	:

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

Provider Enumeration Date	:	11/14/2006
Last Update Date	:	02/05/2024

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