Provider Demographics
NPI:1649789256
Name:KURTZMAN, TAYLER J (MASSAGE THERAPIST)
Entity type:Individual
Prefix:
First Name:TAYLER
Middle Name:J
Last Name:KURTZMAN
Suffix:
Gender:M
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 1:3250 15TH AVE W APT A7
Mailing Address - Street 2:
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98119-1751
Mailing Address - Country:US
Mailing Address - Phone:636-346-0070
Mailing Address - Fax:
Practice Address - Street 1:3250 15TH AVE W APT A7
Practice Address - Street 2:
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98119-1751
Practice Address - Country:US
Practice Address - Phone:636-346-0070
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-09-26
Last Update Date:2017-09-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMA60791049225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist