Doctor Name: | MS. CYNTHIA E ODOM |
NPI Number: | 1396128799 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | LMP |
License Number: | MA60562028 |
Business Practice Address: | 118 S 11th Ave Yakima, WA - 989023204 |
Business Phone Number: | 5093073116 |
Business Fax Number: | 5096780260 |
Mailing Address: | Po Box 311, COWICHE |
State: | WA |
Postal Code: | 989230311 |
Phone Number: | 5093073116 |
Fax Number: | 5096780260 |
NPI Enumeration Date: | 07/02/2015 |
NPI Last Update Date: | 05/12/2016 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 225700000X |
License Number: | MA60562028 |
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. |