Provider Demographics
NPI:1760565683
Name:YOUNG, CATHERINE ELIZABETH (LMP)
Entity Type:Individual
Prefix:
First Name:CATHERINE
Middle Name:ELIZABETH
Last Name:YOUNG
Suffix:
Gender:F
Credentials:LMP
Other - Prefix:
Other - First Name:CATHERINE
Other - Middle Name:ELIZABETH
Other - Last Name:DUKE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LMP
Mailing Address - Street 1:30115 2ND PL SW
Mailing Address - Street 2:
Mailing Address - City:FEDERAL WAY
Mailing Address - State:WA
Mailing Address - Zip Code:98023-3971
Mailing Address - Country:US
Mailing Address - Phone:206-979-2943
Mailing Address - Fax:
Practice Address - Street 1:30115 2ND PL SW
Practice Address - Street 2:
Practice Address - City:FEDERAL WAY
Practice Address - State:WA
Practice Address - Zip Code:98023-3971
Practice Address - Country:US
Practice Address - Phone:206-979-2943
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-23
Last Update Date:2009-09-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMA00021456225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA0217138OtherLABOR AND INDUSTRIES