Data from the NPPES registry. May not reflect recent changes — verify at nppes.cms.hhs.gov.
MR. KENNETH MARK WALLACE JR., LMP
Active Sole ProprietorMR. KENNETH MARK WALLACE JR., LMP is a Massage Therapist healthcare provider located in MERCER ISLAND, Washington. NPI 1346548708 is currently active in the NPPES registry. Verify at CMS.
Massage Therapist · MERCER ISLAND, WA
Registration Details
- NPI Number
- 1346548708
- Provider Type
- Individual
- Gender
- Male
- NPI Issued
- Mar 9, 2011 (15.428993764001 yrs)
- Last Updated
- Mar 29, 2011
- License
-
MA60197801 (WA)
- Sole Proprietor
- Yes
Practice Information
- Address
-
4004 89TH AVE SEMERCER ISLAND, WA, 980404102Browse WA providers · Browse ZIP 98040
- Phone
- 2063968452
- Primary Specialty
-
Massage Therapist
225700000X
Other Massage Therapist Providers in MERCER ISLAND, WA
| Name | Credential | NPI |
|---|---|---|
| MISS TATIANA A. RYANLMP | LMP | 1992924369 |
| MRS. JESSICA DOROTHY JACKSON | L.M.P. | 1689830481 |
| MATHEW SCOTT BLISS | LMP | 1356618854 |
| MS. CHELSEY FAITH PRESTON | LMP | 1104196377 |
| ALAYNA BRAUER | LMP | 1457617227 |
| PATRICIA ZAJAC | — | 1063776193 |
Data sourced from the NPPES National Provider Identifier registry. This information is for informational purposes only and is not a substitute for verifying credentials with the appropriate licensing authority. For official verification, use the NPPES NPI Registry or the relevant state medical board.