Evelyn Coyne
Individual provider Active NPI Massage Therapist · Indianola, WA
NPI 1104378355 · NPPES record last updated Nov 3, 2016
Key facts
- NPI
- 1104378355
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Massage Therapist 225700000X
- License
- MA60686518 (WA)
- Practice address
- 8024 Loughrey Ave NE
Indianola, WA 98342 - Phone
- (360) 265-5406
- NPI assigned
- Nov 3, 2016
- 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
| License | State | Type | Specialty |
|---|---|---|---|
| MA60686518 | WA | MD | Massage Therapist |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Massage Therapist | 225700000X | MA60686518 | WA | Yes |
Addresses
Primary practice location
8024 Loughrey Ave NE
Indianola, WA 98342
Mailing address
PO Box 455
Indianola, WA 98342-0455
Phone (360) 265-5406
Other providers in Indianola, WA
- Axel Therapy PLLC
- Janna L Deardorff
- Sam Elmore
- Cynthia Mancinelli Helgeson
- Adam Jackson
- Little Fern Forest, LLC
All providers in Indianola, WA · Massage Therapist in Washington
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Nov 3, 2016. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.