Provider Demographics
NPI:1033478920
Name:GAO MELENEY, XIU FENG (MASSAGE PRACTITIONER)
Entity Type:Individual
Prefix:
First Name:XIU FENG
Middle Name:
Last Name:GAO MELENEY
Suffix:
Gender:F
Credentials:MASSAGE PRACTITIONER
Other - Prefix:
Other - First Name:XIU FENG
Other - Middle Name:
Other - Last Name:GAO
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:ESTHETICIAN
Mailing Address - Street 1:8723 E MARINGO DR
Mailing Address - Street 2:
Mailing Address - City:SPOKANE
Mailing Address - State:WA
Mailing Address - Zip Code:99212-1822
Mailing Address - Country:US
Mailing Address - Phone:509-228-2046
Mailing Address - Fax:
Practice Address - Street 1:8723 E MARINGO DR
Practice Address - Street 2:
Practice Address - City:SPOKANE
Practice Address - State:WA
Practice Address - Zip Code:99212-1822
Practice Address - Country:US
Practice Address - Phone:509-228-2046
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-05-11
Last Update Date:2012-05-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMA 60267176225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist