Provider Demographics
NPI:1710103593
Name:BUHL, CAMERON E (LMP)
Entity Type:Individual
Prefix:
First Name:CAMERON
Middle Name:E
Last Name:BUHL
Suffix:
Gender:M
Credentials:LMP
Other - Prefix:
Other - First Name:C
Other - Middle Name:C
Other - Last Name:BUHL
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LMP
Mailing Address - Street 1:2722 S MELROSE ST
Mailing Address - Street 2:
Mailing Address - City:TACOMA
Mailing Address - State:WA
Mailing Address - Zip Code:98405-2609
Mailing Address - Country:US
Mailing Address - Phone:253-230-4045
Mailing Address - Fax:
Practice Address - Street 1:2722 S MELROSE ST
Practice Address - Street 2:
Practice Address - City:TACOMA
Practice Address - State:WA
Practice Address - Zip Code:98405-2609
Practice Address - Country:US
Practice Address - Phone:253-230-4045
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-18
Last Update Date:2008-04-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMA00020999225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA213945OtherL&I