NPI 1003956962

Glen Erickson, LMT

Practitioner Massage Therapist Olympia, WA

Practice location

Address: 1217 4th Ave E Suite 200, Olympia, WA 98506-4246
Phone: (360) 570-8151
Fax: (360) 943-6602
Mailing address: 607 Turner St NE, Olympia, WA 98506-4665

Registered specialties

Massage Therapist Primary

Respiratory, Developmental, Rehabilitative and Restorative Service Providers Taxonomy 225700000X Licence MA00014743 (WA)

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Registry record

NPI: 1003956962
Entity type: Individual
Sex (as registered): Male
NPI issued: 7 Feb 2007
Record last updated: 8 Jul 2007

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.