Provider Demographics
NPI:1528408879
Name:MORLEY, TIM D (MASSAGE THERAPIST)
Entity Type:Individual
Prefix:
First Name:TIM
Middle Name:D
Last Name:MORLEY
Suffix:
Gender:M
Credentials:MASSAGE THERAPIST
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 816
Mailing Address - Street 2:
Mailing Address - City:LANGLEY
Mailing Address - State:WA
Mailing Address - Zip Code:98260-0816
Mailing Address - Country:US
Mailing Address - Phone:425-922-2751
Mailing Address - Fax:
Practice Address - Street 1:974 WOODSIDE LN
Practice Address - Street 2:
Practice Address - City:LANGLEY
Practice Address - State:WA
Practice Address - Zip Code:98260-8612
Practice Address - Country:US
Practice Address - Phone:425-922-2751
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-07-01
Last Update Date:2013-07-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMA 5285225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
WAMA 5285OtherWASHINGTON STATE DEPT. OF HEALTH