Provider Demographics
NPI:1346385929
Name:REDPATH, VIRGINIA L (LMP LMT)
Entity Type:Individual
Prefix:MS
First Name:VIRGINIA
Middle Name:L
Last Name:REDPATH
Suffix:
Gender:F
Credentials:LMP LMT
Other - Prefix:
Other - First Name:GINNY
Other - Middle Name:
Other - Last Name:REDPATH
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:
Mailing Address - Street 1:132 N 132ND ST
Mailing Address - Street 2:UNIT 101
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98133
Mailing Address - Country:US
Mailing Address - Phone:206-362-5137
Mailing Address - Fax:206-362-5137
Practice Address - Street 1:1207 N 200TH ST
Practice Address - Street 2:SUITE 107
Practice Address - City:SHORELINE
Practice Address - State:WA
Practice Address - Zip Code:98133
Practice Address - Country:US
Practice Address - Phone:206-533-9999
Practice Address - Fax:206-533-9999
Is Sole Proprietor?:No
Enumeration Date:2007-02-21
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMA00007076225700000X
WA225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA46141OtherL & I
WA22197510000OtherLIFEWISE PROV