Provider Demographics
NPI:1558560037
Name:BUSCH, AIMEE'LEE (LMP)
Entity Type:Individual
Prefix:MS
First Name:AIMEE'LEE
Middle Name:
Last Name:BUSCH
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 1:3113 8TH ST
Mailing Address - Street 2:
Mailing Address - City:EVERETT
Mailing Address - State:WA
Mailing Address - Zip Code:98201-1246
Mailing Address - Country:US
Mailing Address - Phone:360-271-7094
Mailing Address - Fax:
Practice Address - Street 1:AVALON WELLNESS CENTER
Practice Address - Street 2:8821 51ST AVE NE
Practice Address - City:MARYSVILLE
Practice Address - State:WA
Practice Address - Zip Code:98270
Practice Address - Country:US
Practice Address - Phone:360-653-3140
Practice Address - Fax:360-657-4103
Is Sole Proprietor?:Yes
Enumeration Date:2007-07-13
Last Update Date:2007-07-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMA00019911171W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171W00000XOther Service ProvidersContractor