| Angie Tietsort, LMP | |
|
28 North Keller Street, Republic, WA 99166 | |
| (336) 250-8581 | |
| (509) 775-3320 |
| Full Name | Angie Tietsort |
|---|---|
| Gender | Female |
| Speciality | Massage Therapist |
| Location | 28 North Keller Street, Republic, Washington |
| Accepts Medicare Assignments | Does not participate in Medicare Program. She may not accept medicare assignment. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1952766503 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 225700000X | Massage Therapist | MA60613576 (Washington) | Primary |
| Mailing Address | Practice Location Address |
|---|---|
| Angie Tietsort, LMP 4466 Colt Way, Springdale, WA 99173-5100 Ph: (336) 250-8581 | Angie Tietsort, LMP 28 North Keller Street, Republic, WA 99166 Ph: (336) 250-8581 |
Lindsay R Henderson, LMT Massage Therapist Medicare: Not Enrolled in Medicare Practice Location: 16278 N Highway 21, Republic, WA 99166 Phone: 509-207-8268 | |
Clara Denise Wisener, LMP Massage Therapist Medicare: Not Enrolled in Medicare Practice Location: 720 S Clark Ave, Republic, WA 99166 Phone: 509-775-0233 Fax: 509-775-8029 |