Provider Demographics
NPI:1316278146
Name:CRABTREE, LINNEA M (LMT)
Entity type:Individual
Prefix:MS
First Name:LINNEA
Middle Name:M
Last Name:CRABTREE
Suffix:
Gender:F
Credentials:LMT
Other - Prefix:
Other - First Name:LINNEA
Other - Middle Name:M
Other - Last Name:DONAGLIA
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1707 3RD ST SE
Mailing Address - Street 2:SUITE A
Mailing Address - City:PUYALLUP
Mailing Address - State:WA
Mailing Address - Zip Code:98372
Mailing Address - Country:US
Mailing Address - Phone:253-200-2355
Mailing Address - Fax:253-200-2977
Practice Address - Street 1:1707 3RD ST SE
Practice Address - Street 2:SUITE A
Practice Address - City:PUYALLUP
Practice Address - State:WA
Practice Address - Zip Code:98372
Practice Address - Country:US
Practice Address - Phone:253-200-2355
Practice Address - Fax:253-200-2977
Is Sole Proprietor?:No
Enumeration Date:2010-01-18
Last Update Date:2019-12-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMA00011163225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
WAMA00011163OtherSTATE OF WASHINGTON LICENSE