Coral Peters, L.M.P.

Individual provider Active NPI Massage Therapist · Cosmopolis, WA

NPI 1801039003 · NPPES record last updated Apr 17, 2009

Key facts

NPI
1801039003
Entity type
Individual (NPI type 1)
Primary specialty
Massage Therapist 225700000X
License
MA60072538 (WA)
Practice address
1033 1St St
Cosmopolis, WA 98520
Phone
(360) 532-1093
Fax
(360) 533-2058
NPI assigned
Apr 17, 2009
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
MA60072538WAMDMassage Therapist

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Massage Therapist 225700000X MA60072538 WA Yes

Addresses

Primary practice location

1033 1St St
Cosmopolis, WA 98520

Mailing address

1607 S Evans St
Aberdeen, WA 98520-5114
Phone (360) 532-1093

Other identifiers

IdentifierTypeStateIssuer
MA60072538OtherWAWASHINGTON STATE LICENSE NUMBER

Other providers in Cosmopolis, WA

All providers in Cosmopolis, WA · Massage Therapist in Washington

Sources for this page

Verify at the official NPI Registry.