Erica Y Wagoner, LMP
Individual provider Active NPI Massage Therapist · Kennewick, WA
NPI 1497843296 · NPPES record last updated Jul 8, 2007
Key facts
- NPI
- 1497843296
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Massage Therapist 225700000X
- License
- MA00016506 (WA)
- Practice address
- 552 N Colorado St
Ste. 200
Kennewick, WA 99336-7779 - Phone
- (509) 736-6060
- Fax
- (509) 736-3939
- NPI assigned
- Oct 10, 2006
- Sex
- Female
- 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
| License | State | Type | Specialty |
|---|---|---|---|
| MA00016506 | WA | MD | Massage Therapist |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Massage Therapist | 225700000X | MA00016506 | WA | Yes |
Addresses
Primary practice location
552 N Colorado St
Ste. 200
Kennewick, WA 99336-7779
Mailing address
4208 Meadowview Dr
Pasco, WA 99301-9523
Phone (509) 543-9224
Other providers in Kennewick, WA
- Vue Home Care LLC
- Vue Home Health LLC
- Samuel Waayers
- Carrington M Waddoups
- Wesley Allen Wagar
- William S. Waites
- Wal-Mart Stores, Inc
- Linda Lee Walby
- Awnya Walde
- Madison Lee-Ann Waldo
All providers in Kennewick, 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 Jul 8, 2007. 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.