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NPI Code Detail

MEDICARE: AMBER NICOLE PODACH MYERS LMP

MEDICARE: AMBER NICOLE PODACH MYERS 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 TherapistMA60240007WA

General Provider Information

NPI Number : 1083994750
Entity Type Code : Individual
Provider Name (Legal Business Name) : AMBER NICOLE PODACH MYERS LMP
Provider Business Mailing Address
First Line : 2818 E MADISON ST
Second Line :
City : SEATTLE
State : WA
Zip : 98112-4841
Country : US
Telephone Number : 206-397-3590
Fax Number : 206-922-2053
Provider Business Practice Location Address
First Line : 2818 E MADISON ST
Second Line :
City : SEATTLE
State : WA
Zip : 98112-4841
Country : US
Telephone Number : 206-397-3590
Fax Number : 206-922-2053
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/25/2011
Last Update Date : 11/04/2021

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Directions to “ AMBER NICOLE PODACH MYERS LMP” Practice Location

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