Provider Demographics
NPI:1467694190
Name:WILLIAMS, SHEILA MARIE (LMP)
Entity type:Individual
Prefix:MS
First Name:SHEILA
Middle Name:MARIE
Last Name:WILLIAMS
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 1:326 COMMERCIAL ST
Mailing Address - Street 2:
Mailing Address - City:RAYMOND
Mailing Address - State:WA
Mailing Address - Zip Code:98577-2416
Mailing Address - Country:US
Mailing Address - Phone:360-942-2414
Mailing Address - Fax:360-942-2288
Practice Address - Street 1:326 COMMERCIAL ST
Practice Address - Street 2:
Practice Address - City:RAYMOND
Practice Address - State:WA
Practice Address - Zip Code:98577-2416
Practice Address - Country:US
Practice Address - Phone:360-942-2414
Practice Address - Fax:360-942-2288
Is Sole Proprietor?:Yes
Enumeration Date:2009-03-26
Last Update Date:2009-03-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMA00010547174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist