Provider Demographics
NPI:1588964506
Name:KAYDA, LAUREN (LMP)
Entity type:Individual
Prefix:
First Name:LAUREN
Middle Name:
Last Name:KAYDA
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 1:1230 NW 121ST ST
Mailing Address - Street 2:
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98177-4639
Mailing Address - Country:US
Mailing Address - Phone:206-819-3162
Mailing Address - Fax:
Practice Address - Street 1:720 N 35TH ST
Practice Address - Street 2:#202
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98103-8816
Practice Address - Country:US
Practice Address - Phone:206-819-3162
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-10-25
Last Update Date:2011-08-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMA 60171456225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist