Provider Demographics
NPI:1427375070
Name:YOUNG, DEBRA ANN (LMP, REFLEXOLOGIST)
Entity Type:Individual
Prefix:
First Name:DEBRA
Middle Name:ANN
Last Name:YOUNG
Suffix:
Gender:F
Credentials:LMP, REFLEXOLOGIST
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:37428 SE 86TH ST
Mailing Address - Street 2:
Mailing Address - City:SNOQUALMIE
Mailing Address - State:WA
Mailing Address - Zip Code:98065-9306
Mailing Address - Country:US
Mailing Address - Phone:425-478-4905
Mailing Address - Fax:
Practice Address - Street 1:37428 SE 86TH ST
Practice Address - Street 2:
Practice Address - City:SNOQUALMIE
Practice Address - State:WA
Practice Address - Zip Code:98065-9306
Practice Address - Country:US
Practice Address - Phone:425-478-4905
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-04-22
Last Update Date:2011-08-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA173C00000X
WAMA60149890225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist
No173C00000XOther Service ProvidersReflexologist