Provider Demographics
NPI:1396817391
Name:OSINA, SOMER LEE (LMP)
Entity Type:Individual
Prefix:MISS
First Name:SOMER
Middle Name:LEE
Last Name:OSINA
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 1:320 23RD STREET
Mailing Address - Street 2:
Mailing Address - City:HOQUIAM
Mailing Address - State:WA
Mailing Address - Zip Code:98550
Mailing Address - Country:US
Mailing Address - Phone:360-533-6400
Mailing Address - Fax:360-533-6465
Practice Address - Street 1:320 23RD STREET
Practice Address - Street 2:
Practice Address - City:HOQUIAM
Practice Address - State:WA
Practice Address - Zip Code:98550
Practice Address - Country:US
Practice Address - Phone:360-533-6400
Practice Address - Fax:360-533-6465
Is Sole Proprietor?:No
Enumeration Date:2006-11-14
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMA00017715225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA0208995OtherDEPT OF LABOR & INDUSTRIE