CRYSTAL ANN LAKE LMT NPI 1508344383

NPI Information

NPI: 1508344383
Provider Name: CRYSTAL ANN LAKE, LMT
Classification: Massage Therapist - 225700000X
Entity Type: Individual
Address:
5814 GRAHAM AVE STE 101
SUMNER, WA
ZIP 98390
Phone: (253) 891-7093
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Crystal Ann Lake, LMT is a massage therapist in Sumner, WA. The provider is an individual trained in the manipulation of tissues (as by rubbing, stroking, kneading, or tapping) with the hand or an instrument for remedial or hygienic purposes. Crystal Ann Lake, LMT NPI is 1508344383. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a female.

The provider's business location address is:

5814 GRAHAM AVE STE 101
SUMNER, WA
ZIP 98390-728
Phone: (253) 891-7093
Fax: (951) 973-7216

The enumeration date for this NPI number is 8/2/2018 and was last updated on 8/2/2018.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	225700000X	Massage Therapist		MA60879902	WASHINGTON	Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	MA60879902	OTHER	WASHINGTON	MASSAGE THERAPY LICENSE

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 5/5/2024

NPI Synchronization or Removal

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