Provider Demographics
NPI:1528239647
Name:SEELYE, KRISTY J (LMP)
Entity type:Individual
Prefix:MS
First Name:KRISTY
Middle Name:J
Last Name:SEELYE
Suffix:
Gender:F
Credentials:LMP
Other - Prefix:
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Mailing Address - Street 1:209 ORCAS AVE
Mailing Address - Street 2:
Mailing Address - City:PORT ANGELES
Mailing Address - State:WA
Mailing Address - Zip Code:98362-6531
Mailing Address - Country:US
Mailing Address - Phone:360-775-7374
Mailing Address - Fax:360-582-9977
Practice Address - Street 1:660 W EVERGREEN FARM WAY
Practice Address - Street 2:#6065
Practice Address - City:SEQUIM
Practice Address - State:WA
Practice Address - Zip Code:98382-5097
Practice Address - Country:US
Practice Address - Phone:360-582-9977
Practice Address - Fax:360-582-9972
Is Sole Proprietor?:No
Enumeration Date:2008-03-17
Last Update Date:2008-03-17
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
WAMA00017716225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist