Provider Demographics
NPI:1154847929
Name:MAKDA, LUBNA MARIE (LMT)
Entity Type:Individual
Prefix:MS
First Name:LUBNA
Middle Name:MARIE
Last Name:MAKDA
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 1:1002 S PEARL ST
Mailing Address - Street 2:
Mailing Address - City:TACOMA
Mailing Address - State:WA
Mailing Address - Zip Code:98465-2122
Mailing Address - Country:US
Mailing Address - Phone:253-460-8808
Mailing Address - Fax:
Practice Address - Street 1:1002 S PEARL ST
Practice Address - Street 2:
Practice Address - City:TACOMA
Practice Address - State:WA
Practice Address - Zip Code:98465-2122
Practice Address - Country:US
Practice Address - Phone:253-460-8808
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-08-14
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMA60780370225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist