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General NPI Number Information
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NPI Number | 1619675972
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Entity Type | Individual
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Provider Name | MARIAH BURKETT LMT
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Gender | Female
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Dates
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Enumeration Date | 02/16/2023
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Last Update Date | 01/23/2024
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Provider Practice Location Address
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Address Line | 3710 168TH ST NE STE A102
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City | ARLINGTON
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State | WA
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Zip | 98223-8462
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Country | US
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Telephone | 971-328-1293
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Fax | 360-844-1839
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Provider Business Mailing Address
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Address Line | 3629 139TH ST NW
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City | TULALIP
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State | WA
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Zip | 98271-7106
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Country | US
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Telephone | 425-563-5446
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 225700000X
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Taxonomy Name | Massage Therapist
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License Number | MA61406077
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License Number State | WA
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