Provider Demographics
NPI:1558531392
Name:CLEARY, ERIN MARIE (LMT)
Entity Type:Individual
Prefix:
First Name:ERIN
Middle Name:MARIE
Last Name:CLEARY
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 1:19919 WALLINGFORD AVE N
Mailing Address - Street 2:
Mailing Address - City:SHORELINE
Mailing Address - State:WA
Mailing Address - Zip Code:98133-3728
Mailing Address - Country:US
Mailing Address - Phone:206-841-8702
Mailing Address - Fax:
Practice Address - Street 1:19919 WALLINGFORD AVE N
Practice Address - Street 2:
Practice Address - City:SHORELINE
Practice Address - State:WA
Practice Address - Zip Code:98133-3728
Practice Address - Country:US
Practice Address - Phone:206-841-8702
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-03-07
Last Update Date:2019-08-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMA00023992174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist