Provider Demographics
NPI:1073887337
Name:KARPENKO, BROEHE BALLMAN (LMP)
Entity type:Individual
Prefix:MS
First Name:BROEHE
Middle Name:BALLMAN
Last Name:KARPENKO
Suffix:
Gender:F
Credentials:LMP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10021 HOLMAN RD NW
Mailing Address - Street 2:
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98177-4920
Mailing Address - Country:US
Mailing Address - Phone:206-632-8300
Mailing Address - Fax:
Practice Address - Street 1:10021 HOLMAN RD NW
Practice Address - Street 2:
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98177-4920
Practice Address - Country:US
Practice Address - Phone:206-632-8300
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-03-05
Last Update Date:2012-11-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMA000019978225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist