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NPI Code Detail

MEDICARE: KATHLEEN M OSBURN LMP

MEDICARE: KATHLEEN M OSBURN 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 TherapistMA00024032WA

General Provider Information

NPI Number : 1982856365
Entity Type Code : Individual
Provider Name (Legal Business Name) : KATHLEEN M OSBURN LMP
Provider Business Mailing Address
First Line : 13206 NE 36TH ST
Second Line :
City : VANCOUVER
State : WA
Zip : 98682-8828
Country : US
Telephone Number : 360-521-2585
Fax Number :
Provider Business Practice Location Address
First Line : 410 E MAIN ST
Second Line :
City : BATTLE GROUND
State : WA
Zip : 98604-8506
Country : US
Telephone Number : 360-521-2585
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/16/2008
Last Update Date : 10/16/2008

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Directions to “ KATHLEEN M OSBURN LMP” Practice Location

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