MEDICARE: KAYLEY SANDLING 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	MA60647136	WA

General Provider Information

NPI Number	:	1548623960
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	KAYLEY SANDLING LMP

Provider Business Mailing Address
First Line	:	12418 NAOMILAWN DR SW
Second Line	:
City	:	LAKEWOOD
State	:	WA
Zip	:	98498-2522
Country	:	US
Telephone Number	:	360-972-0458
Fax Number	:

Provider Business Practice Location Address
First Line	:	12418 NAOMILAWN DR SW
Second Line	:
City	:	LAKEWOOD
State	:	WA
Zip	:	98498-2522
Country	:	US
Telephone Number	:	360-972-0458
Fax Number	:

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

Provider Enumeration Date	:	04/02/2016
Last Update Date	:	04/02/2016

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Directions to “ KAYLEY SANDLING LMP” Practice Location

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