MEDICARE: ANGELA MAE RODRIGUEZ 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	MA5508797	WA

General Provider Information

NPI Number	:	1972986487
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ANGELA MAE RODRIGUEZ LMP

Provider Business Mailing Address
First Line	:	2002 W VALLEY HWY N
Second Line	:	SUITE 100
City	:	AUBURN
State	:	WA
Zip	:	98001-1630
Country	:	US
Telephone Number	:	253-249-4288
Fax Number	:	253-397-4230

Provider Business Practice Location Address
First Line	:	2002 W VALLEY HWY N
Second Line	:	SUITE 100
City	:	AUBURN
State	:	WA
Zip	:	98001-1630
Country	:	US
Telephone Number	:	253-249-4288
Fax Number	:	253-397-4230

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

Provider Enumeration Date	:	07/01/2015
Last Update Date	:	07/01/2015

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