Provider Demographics
NPI:1023541141
Name:WINTERSET, ASHLEY M (LMP)
Entity Type:Individual
Prefix:MRS
First Name:ASHLEY
Middle Name:M
Last Name:WINTERSET
Suffix:
Gender:F
Credentials:LMP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3103 EASTLAKE AVE E
Mailing Address - Street 2:EASTLAKE MASSAGE
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98102-3801
Mailing Address - Country:US
Mailing Address - Phone:480-825-6090
Mailing Address - Fax:
Practice Address - Street 1:3103 EASTLAKE AVE E
Practice Address - Street 2:EASTLAKE MASSAGE
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98102-3801
Practice Address - Country:US
Practice Address - Phone:480-825-6090
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-04-05
Last Update Date:2017-04-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA60648693225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist