Healthcare Provider Details

I. General information

NPI: 1427272319
Provider Name (Legal Business Name): LAURIE ANNE HUTTON LMP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/12/2007
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

101 N 85TH NORTH END MASSAGE FOR YOUR HEALTH STE 204
SEATTLE WA
98103
US

IV. Provider business mailing address

20126 BALLINGER WAY NE #206
SHORELINE WA
98155
US

V. Phone/Fax

Practice location:
  • Phone: 206-919-2180
  • Fax:
Mailing address:
  • Phone: 206-919-2180
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225700000X
TaxonomyMassage Therapist
License NumberMA00014267
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: