Doctor Name: | GWENNA LYNN ECKERT |
NPI Number: | 1205908423 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | LMP |
License Number: | |
Business Practice Address: | 20833 67th Ave W 301 Lynnwood, WA - 980367365 |
Business Phone Number: | 4257715620 |
Business Fax Number: | 4257744735 |
Mailing Address: | 15914 44th Ave W Apt D103, LYNNWOOD |
State: | WA |
Postal Code: | 980876158 |
Phone Number: | 4256788355 |
Fax Number: | |
NPI Enumeration Date: | 11/14/2006 |
NPI Last Update Date: | 07/08/2007 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 225700000X |
License Number: | |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | |
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. |