Provider Demographics
NPI:1598495897
Name:PODLICH, ALLISON HOPE (LMT)
Entity Type:Individual
Prefix:
First Name:ALLISON
Middle Name:HOPE
Last Name:PODLICH
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 1:145 ROOSTER RDG
Mailing Address - Street 2:
Mailing Address - City:ORONDO
Mailing Address - State:WA
Mailing Address - Zip Code:98843-6000
Mailing Address - Country:US
Mailing Address - Phone:509-679-5288
Mailing Address - Fax:
Practice Address - Street 1:145 ROOSTER RDG
Practice Address - Street 2:
Practice Address - City:ORONDO
Practice Address - State:WA
Practice Address - Zip Code:98843-6000
Practice Address - Country:US
Practice Address - Phone:509-679-5288
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-06-10
Last Update Date:2022-06-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMA60459907225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist