Tatyana Mikhailovna Pidgorodetskaya, LMT
Massage Therapist in Renton, WA. Individual provider (NPI-1).
NPI number1154986321
StatusActive
Last updated in NPPESMay 3, 2019
Details
- NPI
- 1154986321
- Entity type
- Individual (NPI-1)
- Name
- Tatyana Mikhailovna Pidgorodetskaya
- Credential
- LMT
- Sex
- Female
- Sole proprietor
- Yes
- Enumeration date
- May 3, 2019
- Last updated
- May 3, 2019
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 225700000X | Massage Therapist | MA60290361 | WA | Yes |
Practice location
17620 140th Ave SeSuite C-5
Renton, WA 98058
Phone 425-228-2225 · Fax 425-226-3718
Mailing address
17620 140th Ave SeSuite C-5
Renton, WA 98058
Phone 425-228-2225 · Fax 425-226-3718
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