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Mr. Kenneth Mark Wallace JR., LMP
Massage Therapist in Mercer Island, Washington
NPI 1346548708

Kenneth Mark Wallace JR. is a Massage Therapist based in Mercer Island, WA. Kenneth Mark Wallace JR. practices in Mercer Island, WA and has the professional credentials of LMP. The NPI Number for Kenneth Mark Wallace JR. is 1346548708 and holds a License No. MA60197801 (Washington).

The current practice location address for Kenneth Mark Wallace JR. is 4004 89Th Ave Se, Mercer Island, WA and can be reached out via phone at 206-396-8452.

Location: 4004 89Th Ave Se, Mercer Island, WA, 98040-4102
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
person
Provider Profile Details
NPI Number
1346548708
Provider Name
Kenneth Mark Wallace JR.
Credential
LMP
Provider Entity Type
Individual
Gender
Male
Address
4004 89Th Ave Se, Mercer Island, WA, 98040-4102
Phone Number
206-396-8452
Fax Number
Provider Enumeration Date
03/09/2011
Last Update Date
03/09/2024
institution
Provider Business Practice Location Address Details
Address
4004 89Th Ave Se
City
Mercer Island
State
Washington
Zip
98040-4102
Phone Number
206-396-8452
Fax Number
person
Provider Business Mailing Address Details
Address
4004 89Th Ave Se
City
Mercer Island
State
Washington
Zip
98040-4102
Phone Number
206-396-8452
Fax Number
person
Provider's Taxonomy Details 1
Type
Respiratory, Developmental, Rehabilitative and Restorative Service Providers
Classification
Massage Therapist
Speciality
-
Taxonomy
225700000X
License No.
MA60197801 (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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