Provider Demographics
NPI:1093017469
Name:ISENBERG, AMBER (LMT)
Entity Type:Individual
Prefix:
First Name:AMBER
Middle Name:
Last Name:ISENBERG
Suffix:
Gender:F
Credentials:LMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:15108 SE 179TH ST
Mailing Address - Street 2:APT. 3C
Mailing Address - City:RENTON
Mailing Address - State:WA
Mailing Address - Zip Code:98058-9092
Mailing Address - Country:US
Mailing Address - Phone:253-951-5486
Mailing Address - Fax:
Practice Address - Street 1:836 NE NORTHGATE WAY
Practice Address - Street 2:
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98125-7312
Practice Address - Country:US
Practice Address - Phone:206-784-0737
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-11-17
Last Update Date:2010-11-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMA 00016201225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist