Provider Demographics
NPI:1154609915
Name:FRANCKOWIAK, MARIE ANN (LMP)
Entity type:Individual
Prefix:MS
First Name:MARIE
Middle Name:ANN
Last Name:FRANCKOWIAK
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 1:3599 NW CARLTON ST
Mailing Address - Street 2:#4
Mailing Address - City:SILVERDALE
Mailing Address - State:WA
Mailing Address - Zip Code:98383-8324
Mailing Address - Country:US
Mailing Address - Phone:360-801-4545
Mailing Address - Fax:
Practice Address - Street 1:3599 NW CARLTON ST
Practice Address - Street 2:#4
Practice Address - City:SILVERDALE
Practice Address - State:WA
Practice Address - Zip Code:98383-8324
Practice Address - Country:US
Practice Address - Phone:360-801-4545
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-07-28
Last Update Date:2011-07-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMA60238192225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist