Healthcare Provider Details

I. General information

NPI: 1962637447
Provider Name (Legal Business Name): ALLISON SYKES LMP
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/27/2009
Last Update Date: 12/18/2020
Certification Date: 12/18/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3857 MARTIN WAY E
OLYMPIA WA
98506-5268
US

IV. Provider business mailing address

3857 MARTIN WAY E
OLYMPIA WA
98506-5268
US

V. Phone/Fax

Practice location:
  • Phone: 360-704-7170
  • Fax:
Mailing address:
  • Phone: 310-490-8349
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code172M00000X
TaxonomyMechanotherapist
License NumberMA00024509
License Number StateWA
# 2
Primary TaxonomyY
Taxonomy Code101Y00000X
TaxonomyCounselor
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: