MEDICARE: STEPHEN PULLMAN 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
1	225700000X	Massage Therapist	MA60118854	WA
2	174400000X	Specialist	MA60118854	WA

General Provider Information

NPI Number	:	1124355581
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	STEPHEN PULLMAN LMP

Provider Business Mailing Address
First Line	:	7923 32ND AVE SW
Second Line	:
City	:	SEATTLE
State	:	WA
Zip	:	98126-3537
Country	:	US
Telephone Number	:	206-406-8837
Fax Number	:

Provider Business Practice Location Address
First Line	:	7923 32ND AVE SW
Second Line	:
City	:	SEATTLE
State	:	WA
Zip	:	98126-3537
Country	:	US
Telephone Number	:	206-406-8837
Fax Number	:

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

Provider Enumeration Date	:	11/05/2009
Last Update Date	:	12/02/2009

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Directions to “ STEPHEN PULLMAN LMP” Practice Location

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