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NPI Code Detail

MEDICARE: MRS. ABIGAIL ELIZABETH NEWCOMBE LMT

MEDICARE: MRS. ABIGAIL ELIZABETH NEWCOMBE LMT
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 TherapistMA60619676WA

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MA60619676OTHERWAMASSAGE LICENSE

General Provider Information

NPI Number : 1780105676
Entity Type Code : Individual
Provider Name (Legal Business Name) : MRS. ABIGAIL ELIZABETH NEWCOMBE LMT
Provider Business Mailing Address
First Line : 13495 PERCH CIR NW APT D
Second Line :
City : SILVERDALE
State : WA
Zip : 98315-9761
Country : US
Telephone Number : 252-269-8460
Fax Number :
Provider Business Practice Location Address
First Line : 1800 SE MILE HILL DR STE 150
Second Line :
City : PORT ORCHARD
State : WA
Zip : 98366-3517
Country : US
Telephone Number : 360-874-0232
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/29/2017
Last Update Date : 06/29/2017

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