Individual provider · Type 1 NPI

Kenneth Mark Wallace Jr., LMP

Massage Therapist · Mercer Island, WA

NPI number 1346548708 Active

Practice location

4004 89th Ave SE
Mercer Island, WA 98040-4102

Call (206) 396-8452 Map

Specialties and licenses

TaxonomyCodeLicense
Massage Therapist Primary 225700000XMA60197801 (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 1346548708

Kenneth Mark Wallace Jr., LMP's National Provider Identifier is 1346548708, issued on Mar 9, 2011. The primary taxonomy on file is Massage Therapist (225700000X), and the practice location is in Mercer Island, WA. The record was last updated on Mar 29, 2011.