Provider Demographics
NPI:1326651472
Name:GARCIA, EMMANUEL (LMT)
Entity Type:Individual
Prefix:
First Name:EMMANUEL
Middle Name:
Last Name:GARCIA
Suffix:
Gender:M
Credentials:LMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2632 SANDPIPER LOOP
Mailing Address - Street 2:
Mailing Address - City:RICHLAND
Mailing Address - State:WA
Mailing Address - Zip Code:99354-2378
Mailing Address - Country:US
Mailing Address - Phone:541-969-5714
Mailing Address - Fax:
Practice Address - Street 1:604 WILLIAMS BLVD STE A
Practice Address - Street 2:
Practice Address - City:RICHLAND
Practice Address - State:WA
Practice Address - Zip Code:99354-3207
Practice Address - Country:US
Practice Address - Phone:509-946-0631
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-08-28
Last Update Date:2020-08-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMA60812414225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist