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NPI Code Detail

MEDICARE: EMILY ANNE WILSON LMT

MEDICARE:   EMILY ANNE WILSON  LMT
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 TherapistMA60311636WA

General Provider Information

NPI Number : 1730616186
Entity Type Code : Individual
Provider Name (Legal Business Name) : EMILY ANNE WILSON LMT
Provider Business Mailing Address
First Line : 221 KENYON ST NW STE 201
Second Line :
City : OLYMPIA
State : WA
Zip : 98502-4581
Country : US
Telephone Number : 360-352-0211
Fax Number : 360-352-6226
Provider Business Practice Location Address
First Line : 221 KENYON ST NW STE 201
Second Line :
City : OLYMPIA
State : WA
Zip : 98502-4581
Country : US
Telephone Number : 360-352-0211
Fax Number : 360-352-6226
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/16/2017
Last Update Date : 07/21/2022

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Directions to “ EMILY ANNE WILSON LMT” Practice Location

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