Healthcare Provider Details

I. General information

NPI: 1598846206
Provider Name (Legal Business Name): LORI LYNN SYKAS LMP
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/18/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

16714 SMOKEY POINT BLVD
ARLINGTON WA
98223-8410
US

IV. Provider business mailing address

PO BOX 308
ARLINGTON WA
98223-0308
US

V. Phone/Fax

Practice location:
  • Phone: 425-239-5704
  • Fax: 360-435-0112
Mailing address:
  • Phone: 425-239-5704
  • Fax: 360-435-0112

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225700000X
TaxonomyMassage Therapist
License NumberMA16175
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: