Individual provider · Type 1 NPI

Gary Edward Black, LMP

Massage Therapist · Tumwater, WA

NPI number 1427452572 Active

Practice location

205 Clark Pl SE
Tumwater, WA 98501-4062

Call (360) 570-0401 Map

Mailing address

124 Silverthistle Rd
Winlock, WA 98596-9731

Specialties and licenses

TaxonomyCodeLicense
Massage Therapist Primary 225700000XMA 60326924 (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 1427452572

Gary Edward Black, LMP's National Provider Identifier is 1427452572, issued on Oct 17, 2014. The primary taxonomy on file is Massage Therapist (225700000X), and the practice location is in Tumwater, WA. The record was last updated on Oct 17, 2014.