Provider Demographics
NPI:1427111368
Name:CORDES, PAULA MARIE (CERTIFIED MASSAGE PR)
Entity type:Individual
Prefix:
First Name:PAULA
Middle Name:MARIE
Last Name:CORDES
Suffix:
Gender:F
Credentials:CERTIFIED MASSAGE PR
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5533 WASHINGTON WAY
Mailing Address - Street 2:
Mailing Address - City:FELTON
Mailing Address - State:CA
Mailing Address - Zip Code:95018-9220
Mailing Address - Country:US
Mailing Address - Phone:831-335-3303
Mailing Address - Fax:831-335-3303
Practice Address - Street 1:6010 HWY 9
Practice Address - Street 2:SUITE 1
Practice Address - City:FELTON
Practice Address - State:CA
Practice Address - Zip Code:95018-9220
Practice Address - Country:US
Practice Address - Phone:831-335-3303
Practice Address - Fax:831-335-3303
Is Sole Proprietor?:No
Enumeration Date:2006-12-19
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist