Provider Demographics
NPI:1275657124
Name:WILLIAMS, ASHLEY NICOLE (LMP)
Entity Type:Individual
Prefix:
First Name:ASHLEY
Middle Name:NICOLE
Last Name:WILLIAMS
Suffix:
Gender:F
Credentials:LMP
Other - Prefix:
Other - First Name:ASHLEY
Other - Middle Name:
Other - Last Name:MORGAN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LMP
Mailing Address - Street 1:5615 PHINNEY AVE N
Mailing Address - Street 2:APT. 204
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98103-5863
Mailing Address - Country:US
Mailing Address - Phone:917-263-1570
Mailing Address - Fax:
Practice Address - Street 1:1940 116TH AVE NE
Practice Address - Street 2:SUITE 100
Practice Address - City:BELLEVUE
Practice Address - State:WA
Practice Address - Zip Code:98004-3097
Practice Address - Country:US
Practice Address - Phone:425-590-9208
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-03-18
Last Update Date:2017-03-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMA00021633225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist