MEDICARE: MRS. CHRISTINA BURCH 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	MA00023515	WA

General Provider Information

NPI Number	:	1942418041
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. CHRISTINA BURCH LMP

Provider Business Mailing Address
First Line	:	920 VALLEY MALL PKWY
Second Line	:
City	:	E WENATCHEE
State	:	WA
Zip	:	98802-4402
Country	:	US
Telephone Number	:	509-886-0559
Fax Number	:	509-886-8685

Provider Business Practice Location Address
First Line	:	920 VALLEY MALL PKWY
Second Line	:
City	:	E WENATCHEE
State	:	WA
Zip	:	98802-4402
Country	:	US
Telephone Number	:	509-886-0559
Fax Number	:	509-886-8685

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

Provider Enumeration Date	:	05/20/2007
Last Update Date	:	07/08/2007

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