Provider Demographics
NPI:1063551869
Name:GHERMAN, LORI LYNN (LMP LICENSED MASSAGE)
Entity type:Individual
Prefix:MISS
First Name:LORI
Middle Name:LYNN
Last Name:GHERMAN
Suffix:
Gender:F
Credentials:LMP LICENSED MASSAGE
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 222
Mailing Address - Street 2:
Mailing Address - City:ZILLAH
Mailing Address - State:WA
Mailing Address - Zip Code:98953
Mailing Address - Country:US
Mailing Address - Phone:509-969-0927
Mailing Address - Fax:
Practice Address - Street 1:1120 SO 4TH ST
Practice Address - Street 2:YAKIMA VALLEY CHIROPRACTIC CENTER
Practice Address - City:SUNNYSIDE
Practice Address - State:WA
Practice Address - Zip Code:98944
Practice Address - Country:US
Practice Address - Phone:509-837-2600
Practice Address - Fax:509-837-2291
Is Sole Proprietor?:No
Enumeration Date:2007-02-06
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMA00022900225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA216034OtherL AND I