Provider Demographics
NPI:1467228106
Name:DARROW, ASHLEY MAE (LMT #61330918)
Entity Type:Individual
Prefix:
First Name:ASHLEY
Middle Name:MAE
Last Name:DARROW
Suffix:
Gender:F
Credentials:LMT #61330918
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2355 GRIFFIN AVE STE T
Mailing Address - Street 2:
Mailing Address - City:ENUMCLAW
Mailing Address - State:WA
Mailing Address - Zip Code:98022-2440
Mailing Address - Country:US
Mailing Address - Phone:909-705-9345
Mailing Address - Fax:
Practice Address - Street 1:2355 GRIFFIN AVE STE T
Practice Address - Street 2:
Practice Address - City:ENUMCLAW
Practice Address - State:WA
Practice Address - Zip Code:98022-2440
Practice Address - Country:US
Practice Address - Phone:909-705-9345
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-12-04
Last Update Date:2023-12-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA61330918225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist