Doctor Name: | LAUREN MAY WICKEN KUNTZ |
NPI Number: | 1124151824 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | L.M.P. |
License Number: | MA00021520 |
Business Practice Address: | 410 North Bend Way North Bend, WA - 98045 |
Business Phone Number: | 4258885060 |
Business Fax Number: | |
Mailing Address: | 1270 E North Bend Way Unit 22, NORTH BEND |
State: | WA |
Postal Code: | 980459512 |
Phone Number: | |
Fax Number: | |
NPI Enumeration Date: | 03/13/2007 |
NPI Last Update Date: | 07/08/2007 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 225700000X |
License Number: | MA00021520 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | WA |
Taxonomy Type: | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
Taxonomy Classification: | Massage Therapist |
Taxonomy Specialization: | |
Taxonomy Definition: | An individual trained in the manipulation of tissues (as by rubbing, stroking, kneading, or tapping) with the hand or an instrument for remedial or hygienic purposes. |