Provider Demographics
NPI:1386863686
Name:MITCHELL-PARADIS, KAREN LEIGH (LMP)
Entity Type:Individual
Prefix:MS
First Name:KAREN
Middle Name:LEIGH
Last Name:MITCHELL-PARADIS
Suffix:
Gender:F
Credentials:LMP
Other - Prefix:MS
Other - First Name:KAREN
Other - Middle Name:LEIGH
Other - Last Name:MITCHELL
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:2515 E OLIVE ST
Mailing Address - Street 2:
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98122-3035
Mailing Address - Country:US
Mailing Address - Phone:206-329-7274
Mailing Address - Fax:
Practice Address - Street 1:9015 HOLMAN RD NW
Practice Address - Street 2:
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98117-3481
Practice Address - Country:US
Practice Address - Phone:206-217-7671
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-25
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMA00004873225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist