Eudora M Adams, LMP

Individual provider Active NPI Massage Therapist · Puyallup, WA

NPI 1649599762 · NPPES record last updated Jul 30, 2014

Key facts

NPI
1649599762
Entity type
Individual (NPI type 1)
Primary specialty
Massage Therapist 225700000X
License
MA60152831 (WA)
Practice address
12007 149TH St E
Puyallup, WA 98374-3446
Phone
(206) 799-2085
NPI assigned
May 28, 2010
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

LicenseStateTypeSpecialty
MA60152831WAMDMassage Therapist

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Massage Therapist 225700000X MA60152831 WA Yes

Addresses

Primary practice location

12007 149TH St E
Puyallup, WA 98374-3446

Mailing address

12007 149TH St E
Puyallup, WA 98374-3446
Phone (206) 799-2085

Other names

  • Eudora M Ballou Former name

Other providers in Puyallup, WA

All providers in Puyallup, WA · Massage Therapist in Washington

Sources for this page

Verify at the official NPI Registry.