Provider Demographics
NPI:1154479608
Name:WASHBURN, ARLON CRAIG (RMT)
Entity Type:Individual
Prefix:MR
First Name:ARLON
Middle Name:CRAIG
Last Name:WASHBURN
Suffix:
Gender:M
Credentials:RMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2060 E CONTINENTAL BLVD
Mailing Address - Street 2:
Mailing Address - City:SOUTHLAKE
Mailing Address - State:TX
Mailing Address - Zip Code:76092-9768
Mailing Address - Country:US
Mailing Address - Phone:817-421-2331
Mailing Address - Fax:817-421-2418
Practice Address - Street 1:2060 E CONTINENTAL BLVD
Practice Address - Street 2:
Practice Address - City:SOUTHLAKE
Practice Address - State:TX
Practice Address - Zip Code:76092-9768
Practice Address - Country:US
Practice Address - Phone:817-421-2331
Practice Address - Fax:817-421-2418
Is Sole Proprietor?:No
Enumeration Date:2007-01-08
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXMT006474225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXMT006474OtherMASSAGE THERAPY LICENSE