Provider Demographics
NPI:1043357049
Name:KING, LINDA (LMP)
Entity Type:Individual
Prefix:
First Name:LINDA
Middle Name:
Last Name:KING
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 1:111 AVENUE C
Mailing Address - Street 2:SUITE 103
Mailing Address - City:SNOHOMISH
Mailing Address - State:WA
Mailing Address - Zip Code:98290-2766
Mailing Address - Country:US
Mailing Address - Phone:360-862-9808
Mailing Address - Fax:425-397-8010
Practice Address - Street 1:111 AVENUE C
Practice Address - Street 2:SUITE 103
Practice Address - City:SNOHOMISH
Practice Address - State:WA
Practice Address - Zip Code:98290-2766
Practice Address - Country:US
Practice Address - Phone:360-862-9808
Practice Address - Fax:425-397-8010
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-31
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMA00019845225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist