Provider Demographics
NPI:1124204268
Name:REEVES-PIMENTEL, CYNTHIA ILENE (LMP)
Entity Type:Individual
Prefix:MS
First Name:CYNTHIA
Middle Name:ILENE
Last Name:REEVES-PIMENTEL
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 1:8020 77TH ST NE
Mailing Address - Street 2:
Mailing Address - City:MARYSVILLE
Mailing Address - State:WA
Mailing Address - Zip Code:98270-7884
Mailing Address - Country:US
Mailing Address - Phone:206-793-3076
Mailing Address - Fax:360-658-9202
Practice Address - Street 1:8020 77TH ST NE
Practice Address - Street 2:
Practice Address - City:MARYSVILLE
Practice Address - State:WA
Practice Address - Zip Code:98270-7884
Practice Address - Country:US
Practice Address - Phone:206-793-3076
Practice Address - Fax:360-658-9202
Is Sole Proprietor?:Yes
Enumeration Date:2008-01-19
Last Update Date:2008-01-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMA00024265225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist