Provider Demographics
NPI:1497890180
Name:SPAIRRING, PETER (LMP)
Entity Type:Individual
Prefix:MR
First Name:PETER
Middle Name:
Last Name:SPAIRRING
Suffix:
Gender:M
Credentials:LMP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:607 SW GRADU WAY STE 220
Mailing Address - Street 2:
Mailing Address - City:RENTON
Mailing Address - State:WA
Mailing Address - Zip Code:98057
Mailing Address - Country:US
Mailing Address - Phone:425-255-9564
Mailing Address - Fax:425-272-0075
Practice Address - Street 1:607 SW GRADY WAY STE 220
Practice Address - Street 2:
Practice Address - City:RENTON
Practice Address - State:WA
Practice Address - Zip Code:98057
Practice Address - Country:US
Practice Address - Phone:425-255-9564
Practice Address - Fax:425-272-0075
Is Sole Proprietor?:No
Enumeration Date:2007-02-20
Last Update Date:2011-10-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMA000010957225700000X
WAMA00023380225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA1751SPOtherREGENCE PROVIDER NUMBER
WA200792451OtherFIRST CHOICE HEALTH
WA7459168OtherAETNA PROVIDER #
WA1751SPOtherREGENCE PROVIDER NUMBER