MEDICARE: ERIN BUTCHER

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	MA 60534613	WA

General Provider Information

NPI Number	:	1679930507
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ERIN BUTCHER

Provider Business Mailing Address
First Line	:	9812 205TH AVE E STE C
Second Line	:
City	:	BONNEY LAKE
State	:	WA
Zip	:	98391-8382
Country	:	US
Telephone Number	:	253-863-6378
Fax Number	:

Provider Business Practice Location Address
First Line	:	9812 205TH AVE E STE C
Second Line	:
City	:	BONNEY LAKE
State	:	WA
Zip	:	98391-8382
Country	:	US
Telephone Number	:	253-863-6378
Fax Number	:

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

Provider Enumeration Date	:	01/22/2016
Last Update Date	:	12/05/2023

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Directions to “ ERIN BUTCHER ” Practice Location

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