Provider Demographics
NPI:1578685533
Name:AUSTIN, LAURA STOFFER (CERTIFIED ROLFER)
Entity Type:Individual
Prefix:
First Name:LAURA
Middle Name:STOFFER
Last Name:AUSTIN
Suffix:
Gender:F
Credentials:CERTIFIED ROLFER
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:121 N 85TH ST
Mailing Address - Street 2:
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98103-3601
Mailing Address - Country:US
Mailing Address - Phone:206-706-4117
Mailing Address - Fax:
Practice Address - Street 1:121 N 85TH ST
Practice Address - Street 2:
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98103-3601
Practice Address - Country:US
Practice Address - Phone:206-706-4117
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-03
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMA00019994225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist