Provider Demographics
NPI:1154872208
Name:STEWART, ERIN E (DAOM, LMT, LAC)
Entity type:Individual
Prefix:
First Name:ERIN
Middle Name:E
Last Name:STEWART
Suffix:
Gender:F
Credentials:DAOM, LMT, LAC
Other - Prefix:
Other - First Name:EVONNE
Other - Middle Name:
Other - Last Name:NELSON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LMT
Mailing Address - Street 1:5004 HUBBARD HILL RD
Mailing Address - Street 2:
Mailing Address - City:OAK HARBOR
Mailing Address - State:WA
Mailing Address - Zip Code:98277-9613
Mailing Address - Country:US
Mailing Address - Phone:425-318-9561
Mailing Address - Fax:877-393-1378
Practice Address - Street 1:3417 EVANSTON AVE N STE 428
Practice Address - Street 2:
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98103-8970
Practice Address - Country:US
Practice Address - Phone:425-318-9561
Practice Address - Fax:877-393-1378
Is Sole Proprietor?:Yes
Enumeration Date:2016-10-24
Last Update Date:2024-12-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMA00020042225700000X
WAAC60716212171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist
No225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist