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NPI Code Detail

MEDICARE: PAULA A FOSTER LMP

MEDICARE: PAULA A FOSTER 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 TherapistMA00018638WA

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
18931917OTHERWACRIME VICTIMS
23052FOOTHERWAREGENCE BLUE SHIELD
3179439OTHERWADEPT OF LABOR & INDUSTRY

General Provider Information

NPI Number : 1154406601
Entity Type Code : Individual
Provider Name (Legal Business Name) : PAULA A FOSTER LMP
Provider Business Mailing Address
First Line : PO BOX 731269
Second Line :
City : PUYALLUP
State : WA
Zip : 98373-0060
Country : US
Telephone Number : 253-840-2313
Fax Number : 253-840-6340
Provider Business Practice Location Address
First Line : 19820 STATE ROUTE 410 E
Second Line : SUITE 201
City : BONNEY LAKE
State : WA
Zip : 98391-6377
Country : US
Telephone Number : 253-863-7510
Fax Number : 253-863-5970
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/25/2006
Last Update Date : 07/08/2007

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Practice Location Address:
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1700830320 — MARCIE J MILLER LMP
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1760690085 — KRYSTA L BAXTER LMP
Practice Location Address:
19820 STATE ROUTE 410 E , SUITE 201
BONNEY LAKE, WA
98391-6377
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Practice Fax: 253-863-5970
1164628459 — KIMBERLY J COLEMAN DPT
Practice Location Address:
19820 STATE ROUTE 410 E , SUITE 201
BONNEY LAKE, WA
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1295908549 — MRS. TIA SHEPPARD LMP
Practice Location Address:
19820 STATE ROUTE 410 E , STE. 20
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1487819918 — REBEKAH ELIZABETH HAGEN DPT
Practice Location Address:
19820 SR 410 E , STE 201
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98391-6377
Practice Phone: 253-863-7510
Practice Fax: 253-863-5970

Directions to “ PAULA A FOSTER LMP” Practice Location

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