Provider Demographics
NPI:1336308519
Name:BUTLER, HOLLIE ELIZABETH (LMP)
Entity Type:Individual
Prefix:
First Name:HOLLIE
Middle Name:ELIZABETH
Last Name:BUTLER
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 1:2216 N CLEARVIEW DR
Mailing Address - Street 2:
Mailing Address - City:ELLENSBURG
Mailing Address - State:WA
Mailing Address - Zip Code:98926-2323
Mailing Address - Country:US
Mailing Address - Phone:509-312-0010
Mailing Address - Fax:
Practice Address - Street 1:2216 N CLEARVIEW DR
Practice Address - Street 2:
Practice Address - City:ELLENSBURG
Practice Address - State:WA
Practice Address - Zip Code:98926-2323
Practice Address - Country:US
Practice Address - Phone:509-312-0010
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-06-03
Last Update Date:2008-06-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMA60019996225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist