Provider Demographics
NPI:1659423614
Name:MINTIERO, WENDY L (EAMP, LMT)
Entity Type:Individual
Prefix:
First Name:WENDY
Middle Name:L
Last Name:MINTIERO
Suffix:
Gender:F
Credentials:EAMP, LMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4444 WOODLAND PARK AVE N
Mailing Address - Street 2:SUITE 211
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98103-7499
Mailing Address - Country:US
Mailing Address - Phone:206-504-9547
Mailing Address - Fax:
Practice Address - Street 1:4444 WOODLAND PARK AVE N
Practice Address - Street 2:SUITE 211
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98103-7499
Practice Address - Country:US
Practice Address - Phone:206-504-9547
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-18
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMA00003246225700000X
WAAC00000498171100000X, 171100000X
WAMA 3246225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist
No225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist