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NPI Code Detail

MEDICARE: ALICE M AMBROSE LMP

MEDICARE: ALICE M AMBROSE LMP
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1172M00000XMechanotherapistMA00023148WA

General Provider Information

NPI Number : 1427297696
Entity Type Code : Individual
Provider Name (Legal Business Name) : ALICE M AMBROSE LMP
Provider Business Mailing Address
First Line : 4519 1/2 UNIVERSITY WAY NE
Second Line :
City : SEATTLE
State : WA
Zip : 98105-4515
Country : US
Telephone Number : 206-632-5074
Fax Number :
Provider Business Practice Location Address
First Line : 4519 1/2 UNIVERSITY WAY NE
Second Line :
City : SEATTLE
State : WA
Zip : 98105-4515
Country : US
Telephone Number : 206-632-5074
Fax Number : 206-632-9443
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/11/2009
Last Update Date : 02/11/2009

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Directions to “ ALICE M AMBROSE LMP” Practice Location

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