MEDICARE: MS. LILLIAN BARTIS 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	MA60778966	WA

General Provider Information

NPI Number	:	1861919250
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. LILLIAN BARTIS LMT

Provider Business Mailing Address
First Line	:	3616 COLBY AVE # 324
Second Line	:
City	:	EVERETT
State	:	WA
Zip	:	98201-4773
Country	:	US
Telephone Number	:	425-903-0312
Fax Number	:

Provider Business Practice Location Address
First Line	:	4423 S 3RD AVE
Second Line	:
City	:	EVERETT
State	:	WA
Zip	:	98203-2515
Country	:	US
Telephone Number	:	425-315-2505
Fax Number	:

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

Provider Enumeration Date	:	08/25/2017
Last Update Date	:	03/02/2020

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