Doctor Name: | LORI BERNETHY |
NPI Number: | 1033412986 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | LMP |
License Number: | MA00005225 |
Business Practice Address: | 1101 Avenue D Suite D103 Snohomish, WA - 982902083 |
Business Phone Number: | 3605682686 |
Business Fax Number: | 3608628016 |
Mailing Address: | 1101 Avenue D, Suite D103 SNOHOMISH |
State: | WA |
Postal Code: | 982902083 |
Phone Number: | 3605682686 |
Fax Number: | 3608628016 |
NPI Enumeration Date: | 12/15/2010 |
NPI Last Update Date: | 12/15/2010 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 225700000X |
License Number: | MA00005225 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | WA |
Taxonomy Type: | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
Taxonomy Classification: | Massage Therapist |
Taxonomy Specialization: | |
Taxonomy Definition: | 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. |