Provider Demographics
NPI:1720226699
Name:PASLEY, SHIRLEY (LMP)
Entity Type:Individual
Prefix:
First Name:SHIRLEY
Middle Name:
Last Name:PASLEY
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 1:15715 4TH AVE SW
Mailing Address - Street 2:UNIT 2
Mailing Address - City:BURIEN
Mailing Address - State:WA
Mailing Address - Zip Code:98166-2549
Mailing Address - Country:US
Mailing Address - Phone:206-229-9194
Mailing Address - Fax:206-325-9292
Practice Address - Street 1:2324 EASTLAKE AVE E
Practice Address - Street 2:SUITE 100
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98102-3345
Practice Address - Country:US
Practice Address - Phone:206-325-9297
Practice Address - Fax:206-325-9292
Is Sole Proprietor?:Yes
Enumeration Date:2009-01-29
Last Update Date:2011-03-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMA00017985225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist