MEDICARE: ISRAEL A. SANCHEZ LMP, CSCS, RTS

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	60192810	WA

General Provider Information

NPI Number	:	1598066201
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ISRAEL A. SANCHEZ LMP, CSCS, RTS

Provider Business Mailing Address
First Line	:	353 HIGH SCHOOL RD NW
Second Line	:
City	:	BAINBRIDGE ISLAND
State	:	WA
Zip	:	98110-3680
Country	:	US
Telephone Number	:	206-201-2989
Fax Number	:	206-577-3839

Provider Business Practice Location Address
First Line	:	353 HIGH SCHOOL RD NW
Second Line	:
City	:	BAINBRIDGE ISLAND
State	:	WA
Zip	:	98110-3680
Country	:	US
Telephone Number	:	206-201-2989
Fax Number	:	206-577-3839

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

Provider Enumeration Date	:	11/11/2010
Last Update Date	:	10/11/2011

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