Provider Demographics
NPI:1710449137
Name:WARRINGTON, ANASTACIA JAMES (LMT)
Entity Type:Individual
Prefix:
First Name:ANASTACIA
Middle Name:JAMES
Last Name:WARRINGTON
Suffix:
Gender:F
Credentials:LMT
Other - Prefix:
Other - First Name:STACY
Other - Middle Name:JAMES
Other - Last Name:WARRINGTON
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:9833 LAKE STEILACOOM DR SW
Mailing Address - Street 2:
Mailing Address - City:LAKEWOOD
Mailing Address - State:WA
Mailing Address - Zip Code:98498-5712
Mailing Address - Country:US
Mailing Address - Phone:503-502-0309
Mailing Address - Fax:
Practice Address - Street 1:9833 LAKE STEILACOOM DR SW
Practice Address - Street 2:
Practice Address - City:LAKEWOOD
Practice Address - State:WA
Practice Address - Zip Code:98498-5712
Practice Address - Country:US
Practice Address - Phone:503-502-0309
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-04-04
Last Update Date:2019-04-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA60946038225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist