Provider Demographics
NPI:1285909127
Name:COLLINS-BELDIN, JOSHUA ELAN (LMP, CNMT)
Entity type:Individual
Prefix:
First Name:JOSHUA
Middle Name:ELAN
Last Name:COLLINS-BELDIN
Suffix:
Gender:M
Credentials:LMP, CNMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:203 4TH AVE E
Mailing Address - Street 2:OLYMPIA
Mailing Address - City:OLYMPIA
Mailing Address - State:WA
Mailing Address - Zip Code:98501-6983
Mailing Address - Country:US
Mailing Address - Phone:360-639-4321
Mailing Address - Fax:
Practice Address - Street 1:203 4TH AVE E
Practice Address - Street 2:OLYMPIA
Practice Address - City:OLYMPIA
Practice Address - State:WA
Practice Address - Zip Code:98501-6983
Practice Address - Country:US
Practice Address - Phone:360-639-4321
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-03-10
Last Update Date:2012-03-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMA60257357225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist