Provider Demographics
NPI:1942320486
Name:CARDENAS, CARMEN MARSELA (LMP)
Entity type:Individual
Prefix:MS
First Name:CARMEN
Middle Name:MARSELA
Last Name:CARDENAS
Suffix:
Gender:F
Credentials:LMP
Other - Prefix:MRS
Other - First Name:CARMEN
Other - Middle Name:MARSELA
Other - Last Name:WHEELER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LMP
Mailing Address - Street 1:THORNOCK CHIROPRACTIC, PLLC
Mailing Address - Street 2:2935 COVEY LN
Mailing Address - City:SUNNYSIDE
Mailing Address - State:WA
Mailing Address - Zip Code:98944-8941
Mailing Address - Country:US
Mailing Address - Phone:509-839-5656
Mailing Address - Fax:509-839-5682
Practice Address - Street 1:THORNOCK CHIROPRACTIC, PLLC
Practice Address - Street 2:2935 COVEY LN
Practice Address - City:SUNNYSIDE
Practice Address - State:WA
Practice Address - Zip Code:98944-8941
Practice Address - Country:US
Practice Address - Phone:509-839-5656
Practice Address - Fax:509-839-5682
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-29
Last Update Date:2024-06-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMA00014401225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist