Provider Demographics
NPI:1750782512
Name:MENENDEZ, BARBRA (MA60129750)
Entity type:Individual
Prefix:
First Name:BARBRA
Middle Name:
Last Name:MENENDEZ
Suffix:
Gender:F
Credentials:MA60129750
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:115 7TH ST SE
Mailing Address - Street 2:
Mailing Address - City:AUBURN
Mailing Address - State:WA
Mailing Address - Zip Code:98002-6050
Mailing Address - Country:US
Mailing Address - Phone:253-632-1846
Mailing Address - Fax:
Practice Address - Street 1:115 7TH ST SE
Practice Address - Street 2:
Practice Address - City:AUBURN
Practice Address - State:WA
Practice Address - Zip Code:98002-6050
Practice Address - Country:US
Practice Address - Phone:253-632-1846
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-09-11
Last Update Date:2024-09-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMA60129750225700000X, 172M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist
No172M00000XOther Service ProvidersMechanotherapist