Provider Demographics
NPI:1295014645
Name:LLONA, AYLIN EILEEN (LMP)
Entity Type:Individual
Prefix:
First Name:AYLIN
Middle Name:EILEEN
Last Name:LLONA
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 1:4516 UNION BAY PL NE
Mailing Address - Street 2:
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98105-4025
Mailing Address - Country:US
Mailing Address - Phone:206-601-2688
Mailing Address - Fax:
Practice Address - Street 1:4516 UNION BAY PL NE
Practice Address - Street 2:
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98105-4025
Practice Address - Country:US
Practice Address - Phone:206-601-2688
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-08-16
Last Update Date:2012-02-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMA60103907225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist