person
Mr. Kenneth B Ault, LMP
Massage Therapist in Bonney Lake, Washington
NPI 1700878402

Kenneth B Ault is a Massage Therapist based in Puyallup, WA. Kenneth B Ault practices in Bonney Lake, WA and has the professional credentials of LMP. The NPI Number for Kenneth B Ault is 1700878402 and holds a License No. MA00010271 (Washington).

The current practice location address for Kenneth B Ault is 8910 184Th Ave E, Bonney Lake, WA and can be reached out via phone at 253-863-7510 and via fax at 253-863-5970.

Location: 8910 184Th Ave E, Bonney Lake, WA, 98373-0060
person
Provider Profile Details
NPI Number
1700878402
Provider Name
Kenneth B Ault
Credential
LMP
Provider Entity Type
Individual
Gender
Male
Address
8910 184Th Ave E, Bonney Lake, WA, 98373-0060
Phone Number
253-863-7510
Fax Number
253-863-5970
Provider Enumeration Date
08/18/2005
Last Update Date
03/08/2024
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Provider's Legacy Identifiers
Identifier Type State Issuer
8929366 01 WA CRIME VICTIMS
5632AU 01 WA REGENCE BS
146261 01 WA DEPT OF L&I
institution
Provider Business Practice Location Address Details
Address
8910 184Th Ave E
City
State
Zip
98391-8531
Phone Number
253-863-7510
Fax Number
253-863-5970
person
Provider Business Mailing Address Details
Address
8910 184Th Ave E
City
State
Zip
98391-8531
Phone Number
253-863-7510
Fax Number
253-863-5970
person
Provider's Taxonomy Details 1
Type
Respiratory, Developmental, Rehabilitative and Restorative Service Providers
Classification
Massage Therapist
Speciality
-
Taxonomy
License No.
MA00010271 (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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