MS. NICOLE M SMITH LMP 1871586073

Name: MS. NICOLE M SMITH LMP MS. NICOLE M BLUNK LMP Specialty: Massage Therapist Type of Practice: Individual provider Provider/Org: Medical School: Graduation year from medical school: Affiliation:

Practice Type: Respiratory, Developmental, Rehabilitative and Restorative Service Providers Classification: Massage Therapist Specialization: . Definition of Specialty: An individual trained in the manipulation of tissues (as by rubbing, stroking, kneading, or tapping) with the hand or an instrument for remedial or hygienic purposes.

License #(s): MA00010064, , , , License State(s): WA, , , ,

Practice Location: 17650 140TH AVE SE,RENTON,WA,980586814,US Mailing Address: PO BOX 731269,PUYALLUP,WA,983730060,US

Practice location phone #: 4254300700 Practice location fax #: 4254300710 Mailing address Phone #: 2538406448 Mailing Address fax #: 2538406340 Authorized official Name/Telephone #:

Date NPI was obtained: 08/24/2005 Last data data was updated: 07/08/2007 Insurances: