Provider Demographics
NPI:1437607421
Name:BUTLER, AMI (LMP)
Entity Type:Individual
Prefix:
First Name:AMI
Middle Name:
Last Name:BUTLER
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 1:17223 CARWILLIAM LN
Mailing Address - Street 2:
Mailing Address - City:YELM
Mailing Address - State:WA
Mailing Address - Zip Code:98597-9623
Mailing Address - Country:US
Mailing Address - Phone:253-691-6312
Mailing Address - Fax:
Practice Address - Street 1:17223 CARWILLIAM LN
Practice Address - Street 2:
Practice Address - City:YELM
Practice Address - State:WA
Practice Address - Zip Code:98597-9623
Practice Address - Country:US
Practice Address - Phone:253-691-6312
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-09-19
Last Update Date:2016-09-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMA60688180225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist