Provider Demographics
NPI:1609914472
Name:APPLEYARD, KATHLEEN A (LMP)
Entity Type:Individual
Prefix:
First Name:KATHLEEN
Middle Name:A
Last Name:APPLEYARD
Suffix:
Gender:F
Credentials:LMP
Other - Prefix:
Other - First Name:KATHLEEN
Other - Middle Name:A
Other - Last Name:GILLMAN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:20612 MARINE VIEW DR SW
Mailing Address - Street 2:
Mailing Address - City:NORMANDY PARK
Mailing Address - State:WA
Mailing Address - Zip Code:98166-4238
Mailing Address - Country:US
Mailing Address - Phone:206-824-7085
Mailing Address - Fax:
Practice Address - Street 1:20612 MARINE VIEW DR SW
Practice Address - Street 2:
Practice Address - City:NORMANDY PARK
Practice Address - State:WA
Practice Address - Zip Code:98166-4238
Practice Address - Country:US
Practice Address - Phone:206-824-7085
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-02
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMA00006566225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist