Provider Demographics
NPI:1215173588
Name:NEWMAN, NANCY J (LMP)
Entity type:Individual
Prefix:
First Name:NANCY
Middle Name:J
Last Name:NEWMAN
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 1:4227 4TH AVE NW
Mailing Address - Street 2:
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98107-5013
Mailing Address - Country:US
Mailing Address - Phone:206-419-5427
Mailing Address - Fax:206-905-2999
Practice Address - Street 1:4227 4TH AVE NW
Practice Address - Street 2:
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98107-5013
Practice Address - Country:US
Practice Address - Phone:206-419-5427
Practice Address - Fax:206-905-2999
Is Sole Proprietor?:Yes
Enumeration Date:2008-12-17
Last Update Date:2012-03-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA00024649225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist