Provider Demographics
NPI:1336459213
Name:ADAIR, ANITA WENCHING (LMT)
Entity Type:Individual
Prefix:
First Name:ANITA
Middle Name:WENCHING
Last Name:ADAIR
Suffix:
Gender:F
Credentials:LMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:16514 SE 116TH PL
Mailing Address - Street 2:
Mailing Address - City:RENTON
Mailing Address - State:WA
Mailing Address - Zip Code:98059-8326
Mailing Address - Country:US
Mailing Address - Phone:425-687-8680
Mailing Address - Fax:
Practice Address - Street 1:16514 SE 116TH PL
Practice Address - Street 2:
Practice Address - City:RENTON
Practice Address - State:WA
Practice Address - Zip Code:98059-8326
Practice Address - Country:US
Practice Address - Phone:425-687-8680
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-10-13
Last Update Date:2010-10-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMA00018779225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist