Healthcare Provider Details

I. General information

NPI: 1881809929
Provider Name (Legal Business Name): SARAH MCKENZIE ALLENTREECE LMP
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/11/2007
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1408 LAKE TAPPS PKWY E SUITE E 105
AUBURN WA
98092-8158
US

IV. Provider business mailing address

3415 LARSEN AVE
ENUMCLAW WA
98022-6446
US

V. Phone/Fax

Practice location:
  • Phone: 253-735-0123
  • Fax:
Mailing address:
  • Phone: 253-569-2167
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225700000X
TaxonomyMassage Therapist
License NumberMA00023078
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: