Stephanie S Carl, LMP
Individual provider Active NPI Massage Therapist · Othello, WA
NPI 1356986103 · NPPES record last updated Nov 14, 2019
Key facts
- NPI
- 1356986103
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Massage Therapist 225700000X
- License
- MA61005491 (WA)
- Practice address
- 1366 E Larch St
Othello, WA 99344-1535 - Phone
- (509) 989-0122
- NPI assigned
- Nov 14, 2019
- 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 |
|---|---|---|---|
| MA61005491 | WA | MD | Massage Therapist |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Massage Therapist |
225700000X | MA61005491 | WA | Yes |
Addresses
Primary practice location
1366 E Larch St
Othello, WA 99344-1535
Mailing address
1366 E Larch St
Othello, WA 99344-1535
Phone (509) 989-0122
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| CARL-SS119OL | Other | WA | STATE LICENSE NUMBER |
Other providers in Othello, WA
- Ilona Buts
- Kelsey Campbell
- Antelia Cantu
- Priscilla Cantu
- Marisol Cardenas
- Connie Carrigan
- Leigh Castillo
- Rachael Catt
- Anthony Todd Chamberlain
- Jeffrey Chang
All providers in Othello, 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 14, 2019. 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.