Provider Demographics
NPI:1578860284
Name:KATSUDA, LINDA REIKO (LMT)
Entity Type:Individual
Prefix:MS
First Name:LINDA
Middle Name:REIKO
Last Name:KATSUDA
Suffix:
Gender:F
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:P.O. BOX 4904
Mailing Address - Street 2:244 SPOKANE AVE. #3 GOOD MEDICINE MASSAGE
Mailing Address - City:WHITEFISH
Mailing Address - State:MT
Mailing Address - Zip Code:59937
Mailing Address - Country:US
Mailing Address - Phone:406-260-5593
Mailing Address - Fax:
Practice Address - Street 1:244 SPOKANE AVE. #3
Practice Address - Street 2:GOOD MEDICINE MASSAGE
Practice Address - City:WHITEFISH
Practice Address - State:MT
Practice Address - Zip Code:59937
Practice Address - Country:US
Practice Address - Phone:406-260-5593
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-02-15
Last Update Date:2011-02-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MT98225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist