Provider Demographics
NPI:1346082799
Name:AUSTIN, KARI MINNIEMAE (LMT)
Entity type:Individual
Prefix:
First Name:KARI
Middle Name:MINNIEMAE
Last Name:AUSTIN
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 1:23817 109TH STREET CT E
Mailing Address - Street 2:
Mailing Address - City:BUCKLEY
Mailing Address - State:WA
Mailing Address - Zip Code:98321-8701
Mailing Address - Country:US
Mailing Address - Phone:253-209-8535
Mailing Address - Fax:253-862-6002
Practice Address - Street 1:16515 MERIDIAN E STE 103B
Practice Address - Street 2:
Practice Address - City:PUYALLUP
Practice Address - State:WA
Practice Address - Zip Code:98375-6252
Practice Address - Country:US
Practice Address - Phone:253-209-8535
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-06-07
Last Update Date:2024-06-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMA61080571172M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes172M00000XOther Service ProvidersMechanotherapist