Provider Demographics
NPI:1104130715
Name:CADY, KAREN LYNNE (MASSAGE THERAPIST)
Entity type:Individual
Prefix:
First Name:KAREN
Middle Name:LYNNE
Last Name:CADY
Suffix:
Gender:F
Credentials:MASSAGE THERAPIST
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 277
Mailing Address - Street 2:
Mailing Address - City:GREENACRES
Mailing Address - State:WA
Mailing Address - Zip Code:99016-0277
Mailing Address - Country:US
Mailing Address - Phone:509-999-8941
Mailing Address - Fax:
Practice Address - Street 1:116 E MAIN AVE
Practice Address - Street 2:
Practice Address - City:RITZVILLE
Practice Address - State:WA
Practice Address - Zip Code:99169-1406
Practice Address - Country:US
Practice Address - Phone:509-999-8941
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-08-06
Last Update Date:2010-08-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMA 00025120225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist