Provider Demographics
NPI:1588703243
Name:HILL, BETHANY DENEE (LMP)
Entity type:Individual
Prefix:
First Name:BETHANY
Middle Name:DENEE
Last Name:HILL
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 1:11839 22ND AVE SW
Mailing Address - Street 2:
Mailing Address - City:BURIEN
Mailing Address - State:WA
Mailing Address - Zip Code:98146-2502
Mailing Address - Country:US
Mailing Address - Phone:206-406-9775
Mailing Address - Fax:
Practice Address - Street 1:17620 140TH AVE SE
Practice Address - Street 2:STE C-5
Practice Address - City:RENTON
Practice Address - State:WA
Practice Address - Zip Code:98058-6813
Practice Address - Country:US
Practice Address - Phone:425-255-3718
Practice Address - Fax:425-226-3718
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-06
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMA00023505225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist