Healthcare Provider Details

I. General information

NPI: 1629191408
Provider Name (Legal Business Name): KARLYN A ROFF LMP
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/09/2007
Last Update Date: 02/04/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

265 CYPRESS AVE
SNOHOMISH WA
98290-2516
US

IV. Provider business mailing address

PO BOX 133
SNOHOMISH WA
98291-0133
US

V. Phone/Fax

Practice location:
  • Phone: 360-862-9573
  • Fax: 360-862-9572
Mailing address:
  • Phone: 360-862-9573
  • Fax: 360-862-9572

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225700000X
TaxonomyMassage Therapist
License NumberMA00017670
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: