Provider Demographics
NPI:1689861940
Name:THORNQUIST, TRISHA LYNNE (LMP)
Entity Type:Individual
Prefix:MRS
First Name:TRISHA
Middle Name:LYNNE
Last Name:THORNQUIST
Suffix:
Gender:F
Credentials:LMP
Other - Prefix:MISS
Other - First Name:TRISHA
Other - Middle Name:LYNNE
Other - Last Name:GUTING
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:PO BOX 642302
Mailing Address - Street 2:
Mailing Address - City:PULLMAN
Mailing Address - State:WA
Mailing Address - Zip Code:99164-2302
Mailing Address - Country:US
Mailing Address - Phone:509-335-7492
Mailing Address - Fax:509-335-2092
Practice Address - Street 1:1125 NE WASHINGTON ST
Practice Address - Street 2:
Practice Address - City:PULLMAN
Practice Address - State:WA
Practice Address - Zip Code:99164-0001
Practice Address - Country:US
Practice Address - Phone:509-335-7492
Practice Address - Fax:509-335-2092
Is Sole Proprietor?:No
Enumeration Date:2007-10-01
Last Update Date:2007-10-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMA00024570225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist