Diane Kelly Anderson, RN, LMP

Individual provider Active NPI Massage Therapist · Monroe, WA

NPI 1962836825 · NPPES record last updated Aug 28, 2013

Key facts

NPI
1962836825
Entity type
Individual (NPI type 1)
Primary specialty
Massage Therapist 225700000X
License
MA 60400339 (WA)
Practice address
211 W Hill St
Monroe, WA 98272-1404
Phone
(360) 794-6620
NPI assigned
Aug 28, 2013
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
Credentials
Registered Nurse

State licenses

LicenseStateTypeSpecialty
MA 60400339WAMDMassage Therapist

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Massage Therapist 225700000X MA 60400339 WA Yes

Addresses

Primary practice location

211 W Hill St
Monroe, WA 98272-1404

Mailing address

211 W Hill St
Monroe, WA 98272-1404
Phone (360) 794-6620

Other providers in Monroe, WA

All providers in Monroe, WA · Massage Therapist in Washington

Sources for this page

Verify at the official NPI Registry.