Provider Demographics
NPI:1346484953
Name:LEODONES, REANNA (MASSAGE THERAPIST)
Entity Type:Individual
Prefix:MISS
First Name:REANNA
Middle Name:
Last Name:LEODONES
Suffix:
Gender:F
Credentials:MASSAGE THERAPIST
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:284 LEE ST SW
Mailing Address - Street 2:SUITE 128
Mailing Address - City:TUMWATER
Mailing Address - State:WA
Mailing Address - Zip Code:98501-4403
Mailing Address - Country:US
Mailing Address - Phone:360-489-0469
Mailing Address - Fax:
Practice Address - Street 1:284 LEE ST SW
Practice Address - Street 2:SUITE 128
Practice Address - City:TUMWATER
Practice Address - State:WA
Practice Address - Zip Code:98501
Practice Address - Country:US
Practice Address - Phone:360-489-0469
Practice Address - Fax:360-489-0468
Is Sole Proprietor?:Yes
Enumeration Date:2009-04-27
Last Update Date:2009-04-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMA00012042174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist