Provider Demographics
NPI:1376757922
Name:LENTZ, MICHAEL RI HARD (LMP)
Entity Type:Individual
Prefix:MR
First Name:MICHAEL
Middle Name:RI HARD
Last Name:LENTZ
Suffix:
Gender:M
Credentials:LMP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5649 UNIVERSITY WAY NORTHEAST
Mailing Address - Street 2:
Mailing Address - City:SEATTLE,
Mailing Address - State:WA
Mailing Address - Zip Code:98105
Mailing Address - Country:US
Mailing Address - Phone:206-724-5334
Mailing Address - Fax:
Practice Address - Street 1:5649 UNIVERSITY WAY NORTHEAST
Practice Address - Street 2:
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98105
Practice Address - Country:US
Practice Address - Phone:206-724-5334
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-10
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist