Provider Demographics
NPI:1639208002
Name:ATKINSON, TARI DAWN (LMP, LMT)
Entity Type:Individual
Prefix:MISS
First Name:TARI
Middle Name:DAWN
Last Name:ATKINSON
Suffix:
Gender:F
Credentials:LMP, LMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6201 15TH AVE NW
Mailing Address - Street 2:PMB #555
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98107-2306
Mailing Address - Country:US
Mailing Address - Phone:206-714-5015
Mailing Address - Fax:206-352-5330
Practice Address - Street 1:1811 QUEEN ANNE AVE N
Practice Address - Street 2:SUITE #203
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98109-2850
Practice Address - Country:US
Practice Address - Phone:206-714-5015
Practice Address - Fax:206-352-5330
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-03
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMA00013917225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist