Individual provider · Type 1 NPI

Tanna Susan Willis, LCMT

Massage Therapist · Boise, ID

NPI number 1033551015 Active

Practice location

1529 Belmont St
Boise, ID 83725-0001

Call (208) 426-1459 Map

Mailing address

1910 University Dr
Boise, ID 83725-1351

Specialties and licenses

TaxonomyCodeLicense
Massage Therapist Primary 225700000XMAS-732 (ID)
Student Health Clinic/Center 261QS1000X820290701 (ID)

Massage Therapist: An individual trained in the manipulation of tissues (as by rubbing, stroking, kneading, or tapping) with the hand or an instrument for remedial or hygienic purposes.

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About NPI 1033551015

Tanna Susan Willis, LCMT's National Provider Identifier is 1033551015, issued on Jul 19, 2013. The primary taxonomy on file is Massage Therapist (225700000X), and the practice location is in Boise, ID. The record was last updated on Jul 19, 2013.