Provider Demographics
NPI:1578840583
Name:LATHROP, MARY K (LMP)
Entity Type:Individual
Prefix:
First Name:MARY
Middle Name:K
Last Name:LATHROP
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 1:2024 W BRIDGE AVE
Mailing Address - Street 2:
Mailing Address - City:SPOKANE
Mailing Address - State:WA
Mailing Address - Zip Code:99201-1711
Mailing Address - Country:US
Mailing Address - Phone:509-251-9646
Mailing Address - Fax:
Practice Address - Street 1:2024 W BRIDGE AVE
Practice Address - Street 2:
Practice Address - City:SPOKANE
Practice Address - State:WA
Practice Address - Zip Code:99201-1711
Practice Address - Country:US
Practice Address - Phone:509-251-9646
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-11-05
Last Update Date:2011-11-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMA60237987172M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes172M00000XOther Service ProvidersMechanotherapist