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NPI Code Detail

MEDICARE: ROBERT WADE LMP

MEDICARE: ROBERT WADE 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
1225700000XMassage TherapistMA00010740WA

General Provider Information

NPI Number : 1437396710
Entity Type Code : Individual
Provider Name (Legal Business Name) : ROBERT WADE LMP
Provider Business Mailing Address
First Line : 203 14TH AVE E
Second Line :
City : SEATTLE
State : WA
Zip : 98112-5223
Country : US
Telephone Number : 206-323-2225
Fax Number : 206-381-0913
Provider Business Practice Location Address
First Line : 203 14TH AVE E
Second Line :
City : SEATTLE
State : WA
Zip : 98112-5223
Country : US
Telephone Number : 206-323-2225
Fax Number : 206-381-0913
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/08/2009
Last Update Date : 01/08/2009

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