Grey Luna Jack Riverstone

NPI #1235980210 in Redmond, Washington

Provider Information

NPI Number: 1235980210
Entity Type: Individual
Name: Grey Luna Jack Riverstone
Gender: Not Specified
Sole Proprietor: No
Primary Specialty: Massage Therapist
Enumeration Date: Mar 28, 2024
Last Updated: Mar 28, 2024

Practice Location

Address: 16398 NE 85TH ST STE 100
City: Redmond
State: Washington
ZIP Code: 98052-3555
Phone: (425) 636-1569

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Massage Therapist	225700000X	Primary

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