Provider Demographics
NPI:1558516773
Name:TSAI, KENT (LMP)
Entity Type:Individual
Prefix:
First Name:KENT
Middle Name:
Last Name:TSAI
Suffix:
Gender:M
Credentials:LMP
Other - Prefix:
Other - First Name:KUO-CHIU
Other - Middle Name:
Other - Last Name:TSAI
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:LMP
Mailing Address - Street 1:8311 NE 98TH AVE
Mailing Address - Street 2:
Mailing Address - City:VANCOUVER
Mailing Address - State:WA
Mailing Address - Zip Code:98662-2984
Mailing Address - Country:US
Mailing Address - Phone:360-256-1118
Mailing Address - Fax:360-256-1118
Practice Address - Street 1:400 E EVERGREEN BLVD STE 314
Practice Address - Street 2:
Practice Address - City:VANCOUVER
Practice Address - State:WA
Practice Address - Zip Code:98660-3280
Practice Address - Country:US
Practice Address - Phone:360-314-8478
Practice Address - Fax:360-256-1118
Is Sole Proprietor?:Yes
Enumeration Date:2008-12-02
Last Update Date:2009-01-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMA00019861225700000X
OR11414225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist