Susan Cordon Bull, LMP
Individual provider Active NPI Massage Therapist · Duvall, WA
NPI 1194985283 · NPPES record last updated Jun 11, 2008
Key facts
- NPI
- 1194985283
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Massage Therapist 225700000X
- License
- MA00021116 (WA)
- Practice address
- 14524 Main St NE
Suite 115
Duvall, WA 98019-8467 - Phone
- (425) 985-9171
- NPI assigned
- Jun 11, 2008
- 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 |
|---|---|---|---|
| MA00021116 | WA | MD | Massage Therapist |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Massage Therapist | 225700000X | MA00021116 | WA | Yes |
Addresses
Primary practice location
14524 Main St NE
Suite 115
Duvall, WA 98019-8467
Mailing address
14524 Main St NE
Suite 115
Duvall, WA 98019-8467
Phone (425) 985-9171
Other providers in Duvall, WA
- Lisa B Boyd
- Karin E. Brackebusch
- Brandon Tyler DDS PLLC
- Andrew Jerome Brown
- John Stuart Brown
- Amie Burke
- Rochelle Burns
- Carrie M Burnside
- Amy R Bush
- Rachel Christina Byrne
All providers in Duvall, 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 Jun 11, 2008. 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.