Healthcare Provider Details

I. General information

NPI: 1578683413
Provider Name (Legal Business Name): LORI MAE UHLER LMT
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/31/2007
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

211 YELM AVE WEST SUITE A
YELM WA
98597
US

IV. Provider business mailing address

PO BOX 1409
YELM WA
98597-1409
US

V. Phone/Fax

Practice location:
  • Phone: 360-458-7533
  • Fax: 360-458-7699
Mailing address:
  • Phone: 360-458-7533
  • Fax: 360-458-7699

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225700000X
TaxonomyMassage Therapist
License NumberMA00007001
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: