Healthcare Provider Details

I. General information

NPI: 1992868301
Provider Name (Legal Business Name): TAMMIE ELIZABETH WILLIAMS LMP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: TAMMIE ELIZABETH WOOLARD LMP

II. Dates (important events)

Enumeration Date: 12/18/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9015 HOLMAN RD NW STE 3
SEATTLE WA
98117-3481
US

IV. Provider business mailing address

3517 S 263RD ST
KENT WA
98032-7041
US

V. Phone/Fax

Practice location:
  • Phone: 206-782-8500
  • Fax: 206-784-4020
Mailing address:
  • Phone: 253-520-9454
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225700000X
TaxonomyMassage Therapist
License NumberMA00017258
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: