Provider Demographics
NPI:1427272319
Name:HUTTON, LAURIE ANNE (LMP)
Entity type:Individual
Prefix:MS
First Name:LAURIE
Middle Name:ANNE
Last Name:HUTTON
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 1:20126 BALLINGER WAY NE
Mailing Address - Street 2:#206
Mailing Address - City:SHORELINE
Mailing Address - State:WA
Mailing Address - Zip Code:98155
Mailing Address - Country:US
Mailing Address - Phone:206-919-2180
Mailing Address - Fax:
Practice Address - Street 1:101 N 85TH
Practice Address - Street 2:NORTH END MASSAGE FOR YOUR HEALTH STE 204
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98103
Practice Address - Country:US
Practice Address - Phone:206-919-2180
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-04-12
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMA00014267225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA0152835OtherLABOR & INDUSTRIES