Provider Demographics
NPI:1598191041
Name:WILLIAMS, LINDA S
Entity Type:Individual
Prefix:
First Name:LINDA
Middle Name:S
Last Name:WILLIAMS
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 1:201 UNION AVE SE
Mailing Address - Street 2:UNIT 176
Mailing Address - City:RENTON
Mailing Address - State:WA
Mailing Address - Zip Code:98059-5184
Mailing Address - Country:US
Mailing Address - Phone:206-214-8403
Mailing Address - Fax:
Practice Address - Street 1:201 UNION AVE SE
Practice Address - Street 2:UNIT 176
Practice Address - City:RENTON
Practice Address - State:WA
Practice Address - Zip Code:98059-5184
Practice Address - Country:US
Practice Address - Phone:206-214-8403
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-09-16
Last Update Date:2013-09-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMA60404144225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist