Provider Demographics
NPI:1588108658
Name:CUTWAY, LISA MARIE (LMT)
Entity type:Individual
Prefix:
First Name:LISA
Middle Name:MARIE
Last Name:CUTWAY
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 1:12002 ROOSEVELT WAY NE
Mailing Address - Street 2:APT B402
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98125-4925
Mailing Address - Country:US
Mailing Address - Phone:480-326-5142
Mailing Address - Fax:
Practice Address - Street 1:12002 ROOSEVELT WAY NE
Practice Address - Street 2:APT B402
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98125-4925
Practice Address - Country:US
Practice Address - Phone:480-326-5142
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-12-08
Last Update Date:2016-12-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMA60469765225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist