Provider Demographics
NPI:1558796078
Name:CEDARQUIST, NANCY ELIZABETH
Entity Type:Individual
Prefix:
First Name:NANCY
Middle Name:ELIZABETH
Last Name:CEDARQUIST
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7517 89TH STREET CT E
Mailing Address - Street 2:
Mailing Address - City:PUYALLUP
Mailing Address - State:WA
Mailing Address - Zip Code:98371-6581
Mailing Address - Country:US
Mailing Address - Phone:253-678-0599
Mailing Address - Fax:
Practice Address - Street 1:1717 S 324TH ST STE B
Practice Address - Street 2:
Practice Address - City:FEDERAL WAY
Practice Address - State:WA
Practice Address - Zip Code:98003-8500
Practice Address - Country:US
Practice Address - Phone:253-838-6909
Practice Address - Fax:253-661-3610
Is Sole Proprietor?:Yes
Enumeration Date:2013-09-04
Last Update Date:2013-09-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMA 60396987225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
WAMA 60396987OtherLICENSED MASSAGE PRACTIONER