Carlos Cruz, COTA

Individual provider Active NPI Massage Therapist · Carnation, WA

NPI 1033535752 · NPPES record last updated May 13, 2015

Key facts

NPI
1033535752
Entity type
Individual (NPI type 1)
Primary specialty
Massage Therapist 225700000X
License
MA60499241 (WA)
Practice address
4509 B Tolt Ave
Carnation, WA 98014
Phone
(407) 760-1333
NPI assigned
Mar 6, 2014
Sex
Male
Sole proprietor
No

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
OC60416008WAMDOccupational Therapy Assistant
MA60499241WAMDMassage Therapist

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Occupational Therapy Assistant 224Z00000X OC60416008 WA
Massage Therapist 225700000X MA60499241 WA Yes

Addresses

Primary practice location

4509 B Tolt Ave
Carnation, WA 98014

Mailing address

PO Box 1134
Carnation, WA 98014

Other providers in Carnation, WA

All providers in Carnation, WA · Massage Therapist in Washington

Sources for this page

Verify at the official NPI Registry.