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NPI Code Detail

MEDICARE: MS. MARGO LILY CELESTINO LMP

MEDICARE:  MS. MARGO LILY CELESTINO  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
1225700000XMassage TherapistMA00006874WA

General Provider Information

NPI Number : 1831313410
Entity Type Code : Individual
Provider Name (Legal Business Name) : MS. MARGO LILY CELESTINO LMP
Provider Business Mailing Address
First Line : PO BOX 4507
Second Line :
City : ROLLINGBAY
State : WA
Zip : 98061-0507
Country : US
Telephone Number : 206-855-7951
Fax Number :
Provider Business Practice Location Address
First Line : 390 ERICKSEN AVE NE
Second Line :
City : BAINBRIDGE ISLAND
State : WA
Zip : 98110-1854
Country : US
Telephone Number : 206-713-6263
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/12/2007
Last Update Date : 07/08/2007

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Directions to “ MS. MARGO LILY CELESTINO LMP” Practice Location

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