Provider Demographics
NPI:1619100872
Name:KONTOS, MARILEE ANNE (LMP)
Entity Type:Individual
Prefix:MS
First Name:MARILEE
Middle Name:ANNE
Last Name:KONTOS
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 1:15125 SE 235TH ST
Mailing Address - Street 2:
Mailing Address - City:KENT
Mailing Address - State:WA
Mailing Address - Zip Code:98042-4028
Mailing Address - Country:US
Mailing Address - Phone:206-234-7302
Mailing Address - Fax:
Practice Address - Street 1:20410 137TH AVE S.E.
Practice Address - Street 2:
Practice Address - City:KENT
Practice Address - State:WA
Practice Address - Zip Code:98042-3001
Practice Address - Country:US
Practice Address - Phone:206-234-7302
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-09-03
Last Update Date:2009-09-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMA00008484225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist