Provider Demographics
NPI:1326170937
Name:SIMNOWITZ, ARIEL NOVA (LMP)
Entity Type:Individual
Prefix:
First Name:ARIEL
Middle Name:NOVA
Last Name:SIMNOWITZ
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 1:1608 131ST DR NE
Mailing Address - Street 2:
Mailing Address - City:LAKE STEVENS
Mailing Address - State:WA
Mailing Address - Zip Code:98258-8693
Mailing Address - Country:US
Mailing Address - Phone:206-200-0980
Mailing Address - Fax:
Practice Address - Street 1:7307 WOODLAWN AVE NE
Practice Address - Street 2:
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98115-5334
Practice Address - Country:US
Practice Address - Phone:206-713-8887
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-09
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMA00018791174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist