Doctor Name: | JOHN STICKEL |
NPI Number: | 1063821155 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | L.M.P. |
License Number: | MA 00013159 |
Business Practice Address: | 460 Northeast 70th Street Seattle, WA - 98115 |
Business Phone Number: | 2065224000 |
Business Fax Number: | |
Mailing Address: | 117 E Louisa St # 443, SEATTLE |
State: | WA |
Postal Code: | 981023203 |
Phone Number: | 2062268291 |
Fax Number: | |
NPI Enumeration Date: | 08/04/2014 |
NPI Last Update Date: | 08/21/2014 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 225700000X |
License Number: | MA 00013159 |
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. |