Provider Demographics
NPI:1659614642
Name:TODD, ROSARIO G (MA 60301087)
Entity Type:Individual
Prefix:MISS
First Name:ROSARIO
Middle Name:G
Last Name:TODD
Suffix:
Gender:F
Credentials:MA 60301087
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:14608 HIGHWAY 99 STE 309
Mailing Address - Street 2:
Mailing Address - City:LYNNWOOD
Mailing Address - State:WA
Mailing Address - Zip Code:98087-5500
Mailing Address - Country:US
Mailing Address - Phone:425-742-0332
Mailing Address - Fax:425-742-4160
Practice Address - Street 1:14608 HIGHWAY 99 STE 309
Practice Address - Street 2:
Practice Address - City:LYNNWOOD
Practice Address - State:WA
Practice Address - Zip Code:98087-5500
Practice Address - Country:US
Practice Address - Phone:425-742-0332
Practice Address - Fax:425-742-4160
Is Sole Proprietor?:Yes
Enumeration Date:2013-03-28
Last Update Date:2013-03-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMA 60301087173C00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes173C00000XOther Service ProvidersReflexologist