Provider Demographics
NPI:1215089271
Name:GODSEY, CAMEO A R (LMT)
Entity type:Individual
Prefix:MRS
First Name:CAMEO
Middle Name:A R
Last Name:GODSEY
Suffix:
Gender:F
Credentials:LMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:20820 ECHO LK RD
Mailing Address - Street 2:
Mailing Address - City:SNOHOMISH
Mailing Address - State:WA
Mailing Address - Zip Code:98296
Mailing Address - Country:US
Mailing Address - Phone:206-356-0578
Mailing Address - Fax:
Practice Address - Street 1:18500 156TH AVE NE
Practice Address - Street 2:STE 205
Practice Address - City:WOODINVILLE
Practice Address - State:WA
Practice Address - Zip Code:98072
Practice Address - Country:US
Practice Address - Phone:206-356-0578
Practice Address - Fax:425-424-2127
Is Sole Proprietor?:No
Enumeration Date:2007-01-18
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMA00011995225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA0177562OtherLABOR AND INDUSTRY