Provider Demographics
NPI:1467924035
Name:AYERS, ISABELLA LEIGH (LMT)
Entity Type:Individual
Prefix:
First Name:ISABELLA
Middle Name:LEIGH
Last Name:AYERS
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 1:2709 65TH ST SE
Mailing Address - Street 2:
Mailing Address - City:AUBURN
Mailing Address - State:WA
Mailing Address - Zip Code:98092-8345
Mailing Address - Country:US
Mailing Address - Phone:206-359-5049
Mailing Address - Fax:
Practice Address - Street 1:4220 A ST SE STE 103
Practice Address - Street 2:
Practice Address - City:AUBURN
Practice Address - State:WA
Practice Address - Zip Code:98002-8620
Practice Address - Country:US
Practice Address - Phone:253-833-4800
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-12-20
Last Update Date:2018-12-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMA60914783225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist