Provider Demographics
NPI:1093878902
Name:EPP, LORI ANNA (LMP)
Entity Type:Individual
Prefix:
First Name:LORI
Middle Name:ANNA
Last Name:EPP
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:PO BOX 30184
Mailing Address - Street 2:
Mailing Address - City:BELLINGHAM
Mailing Address - State:WA
Mailing Address - Zip Code:98228-2184
Mailing Address - Country:US
Mailing Address - Phone:360-510-8977
Mailing Address - Fax:360-483-1100
Practice Address - Street 1:3201 NORTHWEST AVE
Practice Address - Street 2:8
Practice Address - City:BELLINGHAM
Practice Address - State:WA
Practice Address - Zip Code:98225-1363
Practice Address - Country:US
Practice Address - Phone:360-510-8977
Practice Address - Fax:360-483-1100
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-19
Last Update Date:2008-03-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMA00021486225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist