Provider Demographics
NPI:1700201530
Name:SLEETH, NANCY (LMP)
Entity Type:Individual
Prefix:MRS
First Name:NANCY
Middle Name:
Last Name:SLEETH
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 1:23014 27TH AVE SE
Mailing Address - Street 2:APT 15-107
Mailing Address - City:BOTHELL
Mailing Address - State:WA
Mailing Address - Zip Code:98021-7880
Mailing Address - Country:US
Mailing Address - Phone:206-335-9327
Mailing Address - Fax:
Practice Address - Street 1:23014 27TH AVE SE
Practice Address - Street 2:APT 15-107
Practice Address - City:BOTHELL
Practice Address - State:WA
Practice Address - Zip Code:98021-7880
Practice Address - Country:US
Practice Address - Phone:206-335-9327
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-03-04
Last Update Date:2014-03-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA00013798225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist