Doctor Name: | EVAN LEBOW-WOLF |
NPI Number: | 1063773240 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | LMP, EAMP |
License Number: | MA 60268328 |
Business Practice Address: | 1421 Western Ave Seattle, WA - 981012021 |
Business Phone Number: | 2066243590 |
Business Fax Number: | |
Mailing Address: | 6858 20th Ave Ne, SEATTLE |
State: | WA |
Postal Code: | 981156946 |
Phone Number: | 7342729432 |
Fax Number: | |
NPI Enumeration Date: | 06/04/2012 |
NPI Last Update Date: | 06/04/2012 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 225700000X |
License Number: | MA 60268328 |
Healthcare Provider Taxonomy: (Secondary) | N |
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. |