MEDICARE: MRS. KATHY MARIE MESSER ERICKSON MASSAGE THERAPIST

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	MA00007959	WA

General Provider Information

NPI Number	:	1730383746
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. KATHY MARIE MESSER ERICKSON MASSAGE THERAPIST

Provider Business Mailing Address
First Line	:	1418 S PIONEER WAY
Second Line	:	SUITE E
City	:	MOSES LAKE
State	:	WA
Zip	:	98837
Country	:	US
Telephone Number	:	509-766-8416
Fax Number	:	509-766-6878

Provider Business Practice Location Address
First Line	:	1418 S PIONEER WAY
Second Line	:	SUITE E
City	:	MOSES LAKE
State	:	WA
Zip	:	98837
Country	:	US
Telephone Number	:	509-766-8416
Fax Number	:	509-766-6878

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

Provider Enumeration Date	:	06/13/2007
Last Update Date	:	07/08/2007

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