Provider / Organization | NPI | Date Certified |
---|---|---|
SAMANTHA AVILA | 1609456094 | 2021-04-10 |
Samantha Avila is registered with the National Plan and Provider Enumeration System and has been issued an National Provider Identifier (NPI) of 1609456094. Registration indicates Samantha Avila is a provider of services with a specialization in Respiratory, Developmental, Rehabilitative and Restorative Service Providers, Massage Therapist (Massage Therapist, ) (Massage Therapist, Respiratory, Developmental, Rehabilitative and Restorative Service Providers)
Entity Type | Individual |
Provider Name | Samantha Avila MA60886820 |
Practice Office Address | 200 S TOBIN ST STE A RENTON, WA US |
Practice Office Telephone | 4252497705 |
Practice Office Fax | 4253215508 |
Mailing Address | 2307 NE 4TH ST APT G306 RENTON, WA 980568814 US |
Business Telephone | 7027508348 |
Code | Practice | License No State |
---|---|---|
225700000X PRIMARY | Respiratory, Developmental, Rehabilitative and Restorative Service Providers Massage Therapist Massage Therapist Massage Therapist Respiratory, Developmental, Rehabilitative and Restorative Service Providers | MA60886820
WA |