Provider Demographics
NPI:1578044087
Name:MCFADDEN MORSE, EMMALEE JOY (LMT)
Entity Type:Individual
Prefix:MISS
First Name:EMMALEE
Middle Name:JOY
Last Name:MCFADDEN MORSE
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 1:1911 104TH STREET CT S APT J203
Mailing Address - Street 2:
Mailing Address - City:TACOMA
Mailing Address - State:WA
Mailing Address - Zip Code:98444-7925
Mailing Address - Country:US
Mailing Address - Phone:253-370-5149
Mailing Address - Fax:
Practice Address - Street 1:10614 CANYON RD E
Practice Address - Street 2:
Practice Address - City:PUYALLUP
Practice Address - State:WA
Practice Address - Zip Code:98373-4257
Practice Address - Country:US
Practice Address - Phone:253-535-6006
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-08-22
Last Update Date:2018-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMA60689967225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist