Healthcare Provider Details

I. General information

NPI: 1821641010
Provider Name (Legal Business Name): ANALEIGH MICHELLE OTIS LMT
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/17/2019
Last Update Date: 09/08/2026
Certification Date: 09/08/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

11871 SILVERDALE WAY NW
SILVERDALE WA
98383-9414
US

IV. Provider business mailing address

28982 FALKNER RD NE
POULSBO WA
98370-9358
US

V. Phone/Fax

Practice location:
  • Phone: 360-509-9248
  • Fax: 360-551-4524
Mailing address:
  • Phone: 360-460-0082
  • Fax: 360-551-4524

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225700000X
TaxonomyMassage Therapist
License NumberMA60950525
License Number StateWA
# 2
Primary TaxonomyN
Taxonomy Code374J00000X
TaxonomyDoula
License NumberBD.61640582
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: