MEDICARE: MS. PATRICIA M. LITTLE L.M.P.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	225700000X	Massage Therapist	MA60129379	WA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MA60129379	OTHER	WA	L.M.P. LICENSE

General Provider Information

NPI Number	:	1013247410
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. PATRICIA M. LITTLE L.M.P.

Provider Business Mailing Address
First Line	:	2900 S KING ST APT 108
Second Line	:
City	:	SEATTLE
State	:	WA
Zip	:	98144-2550
Country	:	US
Telephone Number	:	206-322-1323
Fax Number	:

Provider Business Practice Location Address
First Line	:	2900 S KING ST APT 108
Second Line	:
City	:	SEATTLE
State	:	WA
Zip	:	98144-2550
Country	:	US
Telephone Number	:	206-322-1323
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	01/06/2010
Last Update Date	:	04/15/2010

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