Provider Demographics
NPI:1104147537
Name:GALLOWAY, KAYLA FRANCES (LMP)
Entity type:Individual
Prefix:MISS
First Name:KAYLA
Middle Name:FRANCES
Last Name:GALLOWAY
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 1:10831 NE 147TH LN
Mailing Address - Street 2:#R104
Mailing Address - City:BOTHELL
Mailing Address - State:WA
Mailing Address - Zip Code:98011-4884
Mailing Address - Country:US
Mailing Address - Phone:425-984-4264
Mailing Address - Fax:
Practice Address - Street 1:460 NE 70TH STREET
Practice Address - Street 2:
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98115
Practice Address - Country:US
Practice Address - Phone:206-522-4000
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-06-21
Last Update Date:2010-12-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMA60160874225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist