Gina L Ciarlo, LMP.

Individual provider Active NPI Massage Therapist · Sequim, WA

NPI 1578734604 · NPPES record last updated Mar 17, 2008

Key facts

NPI
1578734604
Entity type
Individual (NPI type 1)
Primary specialty
Massage Therapist 225700000X
License
MA00011913 (WA)
Practice address
660 W Evergreen Farm Way
#6065
Sequim, WA 98382-5097
Phone
(360) 582-9977
NPI assigned
Mar 17, 2008
Sex
Female
Sole proprietor
No

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

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
MA00011913WAMDMassage Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Avalon Massage & Day Spa Past Accepting new patients

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Massage Therapist 225700000X MA00011913 WA Yes

Addresses

Primary practice location

660 W Evergreen Farm Way
#6065
Sequim, WA 98382-5097

Mailing address

660 W Evergreen Farm Way
#6065
Sequim, WA 98382-5097
Phone (360) 582-9977

Other providers in Sequim, WA

All providers in Sequim, WA · Massage Therapist in Washington

Sources for this page

Verify at the official NPI Registry.