Provider Demographics
NPI:1518251172
Name:ESSIGMANN, LORI PATRICIA (LMP)
Entity Type:Individual
Prefix:MRS
First Name:LORI
Middle Name:PATRICIA
Last Name:ESSIGMANN
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 1:8626 HONEYSET LN NW
Mailing Address - Street 2:
Mailing Address - City:SILVERDALE
Mailing Address - State:WA
Mailing Address - Zip Code:98383-8847
Mailing Address - Country:US
Mailing Address - Phone:360-471-3398
Mailing Address - Fax:
Practice Address - Street 1:9050 SILVERDALE WAY NW
Practice Address - Street 2:
Practice Address - City:SILVERDALE
Practice Address - State:WA
Practice Address - Zip Code:98383-9198
Practice Address - Country:US
Practice Address - Phone:360-698-0315
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-06-01
Last Update Date:2011-06-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMA 60184713225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist