Provider Demographics
NPI:1114342003
Name:PHILLIPPI, STEVEN SCOTT (LMP)
Entity Type:Individual
Prefix:MR
First Name:STEVEN
Middle Name:SCOTT
Last Name:PHILLIPPI
Suffix:
Gender:M
Credentials:LMP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10833 2ND AVE S
Mailing Address - Street 2:
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98168-1405
Mailing Address - Country:US
Mailing Address - Phone:360-202-0679
Mailing Address - Fax:
Practice Address - Street 1:3400 HARBOR AVE SW
Practice Address - Street 2:STE.#304
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98126-2394
Practice Address - Country:US
Practice Address - Phone:360-202-0679
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-02-28
Last Update Date:2014-02-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMA60441470172M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes172M00000XOther Service ProvidersMechanotherapist