Provider Demographics
NPI:1194922880
Name:GRAHAM, ERIN KATHERINE (LMP)
Entity type:Individual
Prefix:MS
First Name:ERIN
Middle Name:KATHERINE
Last Name:GRAHAM
Suffix:
Gender:F
Credentials:LMP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:17530 NE UNION HILL RD
Mailing Address - Street 2:STE 270
Mailing Address - City:REDMOND
Mailing Address - State:WA
Mailing Address - Zip Code:98052-3387
Mailing Address - Country:US
Mailing Address - Phone:425-558-1266
Mailing Address - Fax:425-558-9549
Practice Address - Street 1:17530 NE UNION HILL RD
Practice Address - Street 2:STE 270
Practice Address - City:REDMOND
Practice Address - State:WA
Practice Address - Zip Code:98052-3387
Practice Address - Country:US
Practice Address - Phone:425-558-1266
Practice Address - Fax:425-558-9549
Is Sole Proprietor?:Yes
Enumeration Date:2007-06-27
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMA0002265225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist