Provider Demographics
NPI:1114290400
Name:CAPEZIO, PREETHIE PEARL (LMP)
Entity Type:Individual
Prefix:MS
First Name:PREETHIE
Middle Name:PEARL
Last Name:CAPEZIO
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 1:404 7TH AVE SE
Mailing Address - Street 2:
Mailing Address - City:OLYMPIA
Mailing Address - State:WA
Mailing Address - Zip Code:98501-1457
Mailing Address - Country:US
Mailing Address - Phone:360-507-3827
Mailing Address - Fax:360-867-1391
Practice Address - Street 1:404 7TH AVE SE
Practice Address - Street 2:
Practice Address - City:OLYMPIA
Practice Address - State:WA
Practice Address - Zip Code:98501-1457
Practice Address - Country:US
Practice Address - Phone:360-507-3827
Practice Address - Fax:360-867-1391
Is Sole Proprietor?:No
Enumeration Date:2012-02-16
Last Update Date:2012-02-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMA00022190225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist