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NPI Code Detail

MEDICARE: MARIAN DIPERNA LMT

MEDICARE: MARIAN DIPERNA LMT
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 Therapist60235348WA

General Provider Information

NPI Number : 1154601185
Entity Type Code : Individual
Provider Name (Legal Business Name) : MARIAN DIPERNA LMT
Provider Business Mailing Address
First Line : 3814 53RD AVE SW
Second Line :
City : SEATTLE
State : WA
Zip : 98116-3623
Country : US
Telephone Number : 206-605-5115
Fax Number :
Provider Business Practice Location Address
First Line : 3727 CALIFORNIA AVE SW STE 2A
Second Line :
City : SEATTLE
State : WA
Zip : 98116-4303
Country : US
Telephone Number : 206-605-5115
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/22/2011
Last Update Date : 03/06/2020

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Directions to “ MARIAN DIPERNA LMT” Practice Location

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