Provider Demographics
NPI:1285291005
Name:WALTER, SHARI (LMT)
Entity type:Individual
Prefix:
First Name:SHARI
Middle Name:
Last Name:WALTER
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 1:4307 FACTORIA BLVD SE STE 2
Mailing Address - Street 2:
Mailing Address - City:BELLEVUE
Mailing Address - State:WA
Mailing Address - Zip Code:98006-1936
Mailing Address - Country:US
Mailing Address - Phone:425-502-9114
Mailing Address - Fax:
Practice Address - Street 1:4307 FACTORIA BLVD SE STE 2
Practice Address - Street 2:
Practice Address - City:BELLEVUE
Practice Address - State:WA
Practice Address - Zip Code:98006-1936
Practice Address - Country:US
Practice Address - Phone:425-502-9114
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-05-28
Last Update Date:2019-05-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMA00003739225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist