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NPI Code Detail

MEDICARE: LENA LIST

MEDICARE: LENA LIST
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
1225700000XMassage TherapistMA60635462WA

General Provider Information

NPI Number : 1356700207
Entity Type Code : Individual
Provider Name (Legal Business Name) : LENA LIST
Provider Business Mailing Address
First Line : PO BOX 73369
Second Line :
City : PUYALLUP
State : WA
Zip : 98373-0369
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 8112 112TH STREET CT E
Second Line :
City : PUYALLUP
State : WA
Zip : 98373-7815
Country : US
Telephone Number : 253-970-8256
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/21/2016
Last Update Date : 02/13/2020

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Directions to “ LENA LIST ” Practice Location

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