Doctor Name: | ANGELA GRANT |
NPI Number: | 1275598567 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | LMP |
License Number: | |
Business Practice Address: | 111 Market St Ne Suite 108 Olympia, WA - 985011008 |
Business Phone Number: | 3607547085 |
Business Fax Number: | 3607543671 |
Mailing Address: | 5210 Corporate Center Loop Se, Suite D LACEY |
State: | WA |
Postal Code: | 985035952 |
Phone Number: | 3604558155 |
Fax Number: | 3604551655 |
NPI Enumeration Date: | 04/19/2006 |
NPI Last Update Date: | 01/16/2009 |
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. |