Sonya C Grace, LMP

Individual provider Active NPI Massage Therapist · Kenmore, WA

NPI 1003974650 · NPPES record last updated Jun 22, 2016

Key facts

NPI
1003974650
Entity type
Individual (NPI type 1)
Primary specialty
Massage Therapist 225700000X
License
MA00012347 (WA)
Practice address
7800 NE Bothell Way
#155
Kenmore, WA 98028
Phone
(206) 729-7429
Fax
(206) 826-0455
NPI assigned
Dec 5, 2006
Sex
Female
Sole proprietor
Yes

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

State licenses

LicenseStateTypeSpecialty
MA00012347WAMDMassage Therapist
MA12347WAMDMassage Therapist

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Massage Therapist 225700000X MA12347 WA
Massage Therapist 225700000X MA00012347 WA Yes

Addresses

Primary practice location

7800 NE Bothell Way
#155
Kenmore, WA 98028

Mailing address

7711 NE 175TH St.
A108
Kenmore, WA 98028
Phone (206) 729-7429

Other names

  • Sonya C Olsby Former name

Other providers in Kenmore, WA

All providers in Kenmore, WA · Massage Therapist in Washington

Sources for this page

Verify at the official NPI Registry.