Most Relevant Information
Provider Data
| NPI Number: | 1003385337 |
| Provider Name: | MITZY DANAE LEEPER LMT, TTT |
| Entity Type: | Individual |
| Taxonomy Code: | 225700000X |
| Specialty: | Massage Therapist |
| License Number: | MA00017300 |
Most Important Dates
| Enumeration Date: | 11/15/2018 |
| Last Updated: | 11/15/2018 |
Provider Practice Location
613 E MCLOUGHLIN BLVD
VANCOUVER
WA
986633358
Practice Location Phone/Fax
| Phone: | 3607721740 |
| Fax: |
Provider Mailing Location
7812 NE 124TH AVE
VANCOUVER
WA
986824146
Provider Mailing Phone/Fax
| Phone: | 3607721740 |
| Fax: |