MR. Michael Wall, LMP

NPI #1356657472 in Bothell, Washington

Provider Information

NPI Number: 1356657472
Entity Type: Individual
Name: MR. Michael Wall, LMP
Gender: Not Specified
Sole Proprietor: Yes
Primary Specialty: Massage Therapist
Credential: LMP
Enumeration Date: Aug 26, 2010
Last Updated: Aug 26, 2010

Practice Location

Address: 18920 BOTHELL WAY NE
Address 2: #204
City: Bothell
State: Washington
ZIP Code: 98011-1981
Phone: (425) 424-3730

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Massage Therapist	225700000X	Primary

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