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Mr. Leonid M Potryasov, MA60290799
Massage Therapist in Vancouver, Washington
NPI 1043550866

Leonid M Potryasov is a Massage Therapist based in Vancouver, WA. Leonid M Potryasov practices in Vancouver, WA and has the professional credentials of MA60290799. The NPI Number for Leonid M Potryasov is 1043550866 and holds a License No. 602329198 (Washington).

The current practice location address for Leonid M Potryasov is 11300 Ne Fourth Plain Blvd, Vancouver, WA and can be reached out via phone at 360-931-8054 and via fax at 360-882-8088.

Location: 11300 Ne Fourth Plain Blvd, Vancouver, WA, 98662-5767
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
person
Provider Profile Details
NPI Number
1043550866
Provider Name
Leonid M Potryasov
Credential
MA60290799
Provider Entity Type
Individual
Gender
Male
Address
11300 Ne Fourth Plain Blvd, Vancouver, WA, 98662-5767
Phone Number
360-931-8054
Fax Number
360-882-8088
Provider Enumeration Date
02/15/2013
Last Update Date
03/09/2024
institution
Provider Business Practice Location Address Details
Address
11300 Ne Fourth Plain Blvd
City
Vancouver
State
Washington
Zip
98662-5767
Phone Number
360-931-8054
Fax Number
360-882-8088
person
Provider Business Mailing Address Details
Address
11300 Ne Fourth Plain Blvd
City
Vancouver
State
Washington
Zip
98662-5767
Phone Number
360-931-8054
Fax Number
360-882-8088
person
Provider's Taxonomy Details 1
Type
Respiratory, Developmental, Rehabilitative and Restorative Service Providers
Classification
Massage Therapist
Speciality
-
Taxonomy
225700000X
License No.
602329198 (Washington)
Definition
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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