Provider Demographics
NPI:1609884113
Name:WILLIAMS, ROSINA LOUISE (LMP)
Entity Type:Individual
Prefix:MRS
First Name:ROSINA
Middle Name:LOUISE
Last Name:WILLIAMS
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 1:22412 153RD AVE SE
Mailing Address - Street 2:
Mailing Address - City:SNOHOMISH
Mailing Address - State:WA
Mailing Address - Zip Code:98296-6186
Mailing Address - Country:US
Mailing Address - Phone:425-879-5484
Mailing Address - Fax:360-805-0518
Practice Address - Street 1:1715 100TH PL SE STE A
Practice Address - Street 2:
Practice Address - City:EVERETT
Practice Address - State:WA
Practice Address - Zip Code:98208-3846
Practice Address - Country:US
Practice Address - Phone:425-879-5484
Practice Address - Fax:360-805-0518
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-03
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMA00016492225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist