MEDICARE: MR. GIL BAR-SELA 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	MA60270932	WA

General Provider Information

NPI Number	:	1750656112
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MR. GIL BAR-SELA LMP

Provider Business Mailing Address
First Line	:	911 21ST AVE
Second Line	:
City	:	SEATTLE
State	:	WA
Zip	:	98122-4758
Country	:	US
Telephone Number	:	917-294-7919
Fax Number	:

Provider Business Practice Location Address
First Line	:	907 21ST AVE
Second Line	:
City	:	SEATTLE
State	:	WA
Zip	:	98122-4758
Country	:	US
Telephone Number	:	917-294-7919
Fax Number	:

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

Provider Enumeration Date	:	03/19/2012
Last Update Date	:	03/21/2012

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