Provider Demographics
NPI:1255679098
Name:STRAUS, CORTNEY MARIE (LMP)
Entity Type:Individual
Prefix:MISS
First Name:CORTNEY
Middle Name:MARIE
Last Name:STRAUS
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 1:307 9TH ST NW
Mailing Address - Street 2:APT. #1
Mailing Address - City:PUYALLUP
Mailing Address - State:WA
Mailing Address - Zip Code:98371-4389
Mailing Address - Country:US
Mailing Address - Phone:253-219-1402
Mailing Address - Fax:
Practice Address - Street 1:307 9TH ST NW
Practice Address - Street 2:APT. #1
Practice Address - City:PUYALLUP
Practice Address - State:WA
Practice Address - Zip Code:98371-4389
Practice Address - Country:US
Practice Address - Phone:253-219-1402
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-01-29
Last Update Date:2013-01-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA60275834225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist