Provider Demographics
NPI:1528303096
Name:ABRAMOWSKI, PAUL AARON (LMP)
Entity type:Individual
Prefix:
First Name:PAUL
Middle Name:AARON
Last Name:ABRAMOWSKI
Suffix:
Gender:M
Credentials:LMP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1009 DENNY AVE
Mailing Address - Street 2:
Mailing Address - City:CLE ELUM
Mailing Address - State:WA
Mailing Address - Zip Code:98922-1402
Mailing Address - Country:US
Mailing Address - Phone:630-740-9521
Mailing Address - Fax:
Practice Address - Street 1:202 W 1ST ST
Practice Address - Street 2:SUITE 1
Practice Address - City:CLE ELUM
Practice Address - State:WA
Practice Address - Zip Code:98922-1154
Practice Address - Country:US
Practice Address - Phone:509-674-5057
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-12-10
Last Update Date:2012-12-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA225700000X390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program