Doctor Name: | LEILANI MOCK |
NPI Number: | 1700074499 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | LMP |
License Number: | MA00024496 |
Business Practice Address: | 1175 Center Dr 160 Dupont, WA - 983277733 |
Business Phone Number: | 2539641559 |
Business Fax Number: | 2539648495 |
Mailing Address: | Po Box 11009, OLYMPIA |
State: | WA |
Postal Code: | 985081009 |
Phone Number: | 3603522037 |
Fax Number: | |
NPI Enumeration Date: | 10/09/2007 |
NPI Last Update Date: | 01/03/2008 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 225700000X |
License Number: | MA00024496 |
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. |