MEDICARE: CHANTEL N TODD 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
1	225700000X	Massage Therapist	61413166	WA

General Provider Information

NPI Number	:	1881495687
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	CHANTEL N TODD LMT

Provider Business Mailing Address
First Line	:	4544 CREEKVIEW LN NW
Second Line	:
City	:	OLYMPIA
State	:	WA
Zip	:	98502-9741
Country	:	US
Telephone Number	:	808-268-4558
Fax Number	:

Provider Business Practice Location Address
First Line	:	1303 4TH AVE E
Second Line	:
City	:	OLYMPIA
State	:	WA
Zip	:	98506-4245
Country	:	US
Telephone Number	:	360-918-8335
Fax Number	:

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

Provider Enumeration Date	:	03/19/2025
Last Update Date	:	03/19/2025

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