MEDICARE: SORA CHAPMAN 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
1	225700000X	Massage Therapist

General Provider Information

NPI Number	:	1528686599
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SORA CHAPMAN LMT

Provider Business Mailing Address
First Line	:	607 SARATOGA ST
Second Line	:
City	:	GRANITE FALLS
State	:	WA
Zip	:	98252-8715
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	9623 32ND ST SE STE A113
Second Line	:
City	:	LAKE STEVENS
State	:	WA
Zip	:	98258-5798
Country	:	US
Telephone Number	:	206-697-4152
Fax Number	:

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

Provider Enumeration Date	:	07/07/2020
Last Update Date	:	07/07/2020

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