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NPI Code Detail

MEDICARE: BOBBY WHITE LMP

MEDICARE: BOBBY WHITE LMP
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
1225700000XMassage TherapistMA 60173939WA

General Provider Information

NPI Number : 1043510753
Entity Type Code : Individual
Provider Name (Legal Business Name) : BOBBY WHITE LMP
Provider Business Mailing Address
First Line : 22906 39TH AVE W
Second Line :
City : BRIER
State : WA
Zip : 98036-8281
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 6515 132ND AVE NE
Second Line :
City : KIRKLAND
State : WA
Zip : 98033-8628
Country : US
Telephone Number : 425-822-4326
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/27/2010
Last Update Date : 10/27/2010

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Directions to “ BOBBY WHITE LMP” Practice Location

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