Healthcare Provider Details

I. General information

NPI: 1073479200
Provider Name (Legal Business Name): MARIA LORENA PALMA CHAVEZ LMT
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/31/2025
Last Update Date: 12/31/2025
Certification Date: 12/31/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

15 SW EVERETT MALL WAY STE G
EVERETT WA
98204-2715
US

IV. Provider business mailing address

15 SW EVERETT MALL WAY STE G
EVERETT WA
98204-2715
US

V. Phone/Fax

Practice location:
  • Phone: 425-355-5222
  • Fax: 425-355-5231
Mailing address:
  • Phone: 425-355-5222
  • Fax: 425-355-5231

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225700000X
TaxonomyMassage Therapist
License NumberMA70070290
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: