Provider Demographics
NPI:1417606781
Name:ZAMARRON-PRIEBE, ALEXIS ANTONIA (LMT)
Entity Type:Individual
Prefix:
First Name:ALEXIS
Middle Name:ANTONIA
Last Name:ZAMARRON-PRIEBE
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 1:9608 175TH STREET CT E
Mailing Address - Street 2:
Mailing Address - City:PUYALLUP
Mailing Address - State:WA
Mailing Address - Zip Code:98375-2022
Mailing Address - Country:US
Mailing Address - Phone:719-258-7904
Mailing Address - Fax:
Practice Address - Street 1:6020 MAIN ST SW STE C
Practice Address - Street 2:
Practice Address - City:LAKEWOOD
Practice Address - State:WA
Practice Address - Zip Code:98499-6506
Practice Address - Country:US
Practice Address - Phone:253-426-1000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-03-22
Last Update Date:2022-03-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMASS.MA.61052955225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist