Individual provider · Type 1 NPI

Shonelle Uilani Pascua Gongob, LMP

Massage Therapist · Lakewood, WA

NPI number 1245588490 Active

Practice location

7308 Bridgeport Way W, Ste. 103
Lakewood, WA 98499-8000

Call (253) 582-8142 Map

Fax (253) 582-8160

Mailing address

4040 Orchard St W, Ste. 100
Fircrest, WA 98466-6606

Specialties and licenses

TaxonomyCodeLicense
Massage Therapist Primary 225700000XMA60290683 (WA)

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 1245588490

Shonelle Uilani Pascua Gongob, LMP's National Provider Identifier is 1245588490, issued on Aug 20, 2012. The primary taxonomy on file is Massage Therapist (225700000X), and the practice location is in Lakewood, WA. The record was last updated on Aug 20, 2012.