Provider Demographics
NPI:1467944744
Name:FRANTZ, NIKKI JANE (LMT)
Entity Type:Individual
Prefix:
First Name:NIKKI
Middle Name:JANE
Last Name:FRANTZ
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 1:6813 82ND AVE NW
Mailing Address - Street 2:
Mailing Address - City:GIG HARBOR
Mailing Address - State:WA
Mailing Address - Zip Code:98335-6216
Mailing Address - Country:US
Mailing Address - Phone:253-219-8883
Mailing Address - Fax:
Practice Address - Street 1:4113 BRIDGEPORT WAY W STE B
Practice Address - Street 2:
Practice Address - City:UNIVERSITY PLACE
Practice Address - State:WA
Practice Address - Zip Code:98466-4325
Practice Address - Country:US
Practice Address - Phone:253-564-5828
Practice Address - Fax:253-564-0115
Is Sole Proprietor?:No
Enumeration Date:2018-06-03
Last Update Date:2018-06-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMA60855952225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
WAMA60855952OtherWA DEPARTMENT OF HEALTH