Provider Demographics
NPI:1164062048
Name:TODD, HARRY PRICE III (MA61026929)
Entity Type:Individual
Prefix:MR
First Name:HARRY
Middle Name:PRICE
Last Name:TODD
Suffix:III
Gender:M
Credentials:MA61026929
Other - Prefix:MR
Other - First Name:HARRY
Other - Middle Name:PRICE
Other - Last Name:TODD
Other - Suffix:III
Other - Last Name Type:Professional Name
Other - Credentials:MA61026929
Mailing Address - Street 1:12250 GREENWOOD AVE N APT 210
Mailing Address - Street 2:
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98133-8167
Mailing Address - Country:US
Mailing Address - Phone:971-344-0663
Mailing Address - Fax:
Practice Address - Street 1:15513 AMBAUM BLVD SW
Practice Address - Street 2:
Practice Address - City:BURIEN
Practice Address - State:WA
Practice Address - Zip Code:98166-2424
Practice Address - Country:US
Practice Address - Phone:206-244-7973
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-01-08
Last Update Date:2020-01-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMA61026929225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist