Provider Demographics
NPI:1285900175
Name:ROBINSON, AWHINA MANEA (LMP)
Entity type:Individual
Prefix:MISS
First Name:AWHINA
Middle Name:MANEA
Last Name:ROBINSON
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 1:9505 BRIDGE RD SE
Mailing Address - Street 2:
Mailing Address - City:YELM
Mailing Address - State:WA
Mailing Address - Zip Code:98597-9640
Mailing Address - Country:US
Mailing Address - Phone:360-458-4350
Mailing Address - Fax:
Practice Address - Street 1:284 LEE ST SW
Practice Address - Street 2:SUITE 128
Practice Address - City:TUMWATER
Practice Address - State:WA
Practice Address - Zip Code:98501-4403
Practice Address - Country:US
Practice Address - Phone:360-489-0469
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-03-26
Last Update Date:2012-03-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA60275813225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist