Provider Demographics
NPI:1598182248
Name:SUMMERS, CELINA (LMP)
Entity Type:Individual
Prefix:
First Name:CELINA
Middle Name:
Last Name:SUMMERS
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 1:22 W CENTRAL AVE
Mailing Address - Street 2:
Mailing Address - City:SPOKANE
Mailing Address - State:WA
Mailing Address - Zip Code:99205-6221
Mailing Address - Country:US
Mailing Address - Phone:509-484-7578
Mailing Address - Fax:509-484-9441
Practice Address - Street 1:22 W CENTRAL AVE
Practice Address - Street 2:
Practice Address - City:SPOKANE
Practice Address - State:WA
Practice Address - Zip Code:99205-6221
Practice Address - Country:US
Practice Address - Phone:509-484-7578
Practice Address - Fax:509-484-9441
Is Sole Proprietor?:No
Enumeration Date:2014-03-19
Last Update Date:2014-03-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMA60326934225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist