Provider Demographics
NPI:1790866234
Name:SIPIORSKI, KATHERINE EVE (LMT)
Entity Type:Individual
Prefix:MRS
First Name:KATHERINE
Middle Name:EVE
Last Name:SIPIORSKI
Suffix:
Gender:F
Credentials:LMT
Other - Prefix:
Other - First Name:KATHERINE
Other - Middle Name:EVE SIPIORSKI
Other - Last Name:DUERR
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LMP
Mailing Address - Street 1:PO BOX 78063
Mailing Address - Street 2:
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98178-0063
Mailing Address - Country:US
Mailing Address - Phone:206-931-2907
Mailing Address - Fax:
Practice Address - Street 1:11521 NE 21ST ST
Practice Address - Street 2:
Practice Address - City:BELLEVUE
Practice Address - State:WA
Practice Address - Zip Code:98004-3026
Practice Address - Country:US
Practice Address - Phone:206-931-2907
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-18
Last Update Date:2017-04-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMA00021057225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist