Provider Demographics
NPI:1013027796
Name:NEPUTE, MERCEDES M (LMPF)
Entity Type:Individual
Prefix:
First Name:MERCEDES
Middle Name:M
Last Name:NEPUTE
Suffix:
Gender:F
Credentials:LMPF
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:412 NORTH K ST
Mailing Address - Street 2:#3
Mailing Address - City:TACOMA
Mailing Address - State:WA
Mailing Address - Zip Code:98403-1636
Mailing Address - Country:US
Mailing Address - Phone:253-627-1489
Mailing Address - Fax:
Practice Address - Street 1:3015 BRIDGEPORT WAY W
Practice Address - Street 2:
Practice Address - City:UNIVERSITY PLACE
Practice Address - State:WA
Practice Address - Zip Code:98466
Practice Address - Country:US
Practice Address - Phone:253-627-1489
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-08-30
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMA00015568225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA0172568OtherL&I