Provider Demographics
NPI:1780044891
Name:SEITZ, SHERRY LEA (LMP)
Entity Type:Individual
Prefix:
First Name:SHERRY
Middle Name:LEA
Last Name:SEITZ
Suffix:
Gender:F
Credentials:LMP
Other - Prefix:
Other - First Name:SHERRY
Other - Middle Name:LEA
Other - Last Name:STEFFLER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LMP
Mailing Address - Street 1:919 S AUBURN ST
Mailing Address - Street 2:SUITE A
Mailing Address - City:KENNEWICK
Mailing Address - State:WA
Mailing Address - Zip Code:99336-5662
Mailing Address - Country:US
Mailing Address - Phone:509-491-3889
Mailing Address - Fax:509-491-3649
Practice Address - Street 1:919 S AUBURN ST
Practice Address - Street 2:SUITE A
Practice Address - City:KENNEWICK
Practice Address - State:WA
Practice Address - Zip Code:99336-5662
Practice Address - Country:US
Practice Address - Phone:509-491-3889
Practice Address - Fax:509-491-3649
Is Sole Proprietor?:No
Enumeration Date:2016-03-02
Last Update Date:2016-03-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMA00013471225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist