Provider Demographics
NPI:1316073232
Name:RHODES, KAY CHRISTINE (LMP)
Entity type:Individual
Prefix:MS
First Name:KAY
Middle Name:CHRISTINE
Last Name:RHODES
Suffix:
Gender:F
Credentials:LMP
Other - Prefix:MS
Other - First Name:KATIE
Other - Middle Name:CHRISTINE
Other - Last Name:RHODES
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:LMP
Mailing Address - Street 1:19524 64TH AVE NE
Mailing Address - Street 2:
Mailing Address - City:KENMORE
Mailing Address - State:WA
Mailing Address - Zip Code:98028-3337
Mailing Address - Country:US
Mailing Address - Phone:425-770-6775
Mailing Address - Fax:585-486-7502
Practice Address - Street 1:19524 64TH AVE NE
Practice Address - Street 2:
Practice Address - City:KENMORE
Practice Address - State:WA
Practice Address - Zip Code:98028-3337
Practice Address - Country:US
Practice Address - Phone:425-770-6775
Practice Address - Fax:585-486-7502
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-26
Last Update Date:2008-10-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMA00023827225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist