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NPI Code Detail

MEDICARE: SABRINA LYNN REYNOLDS LMP

MEDICARE: SABRINA LYNN REYNOLDS 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 TherapistMA00024929WA

General Provider Information

NPI Number : 1205012671
Entity Type Code : Individual
Provider Name (Legal Business Name) : SABRINA LYNN REYNOLDS 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 :
Provider Business Practice Location Address
First Line : 17650 140TH AVE SE
Second Line : #B-07
City : RENTON
State : WA
Zip : 98058-6814
Country : US
Telephone Number : 425-430-0700
Fax Number : 425-430-0710
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/16/2008
Last Update Date : 01/16/2008

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Directions to “ SABRINA LYNN REYNOLDS LMP” Practice Location

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