Provider Demographics
NPI:1790908804
Name:SNOW, BETH A (LMP)
Entity Type:Individual
Prefix:MS
First Name:BETH
Middle Name:A
Last Name:SNOW
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 1:1210 10TH ST
Mailing Address - Street 2:201
Mailing Address - City:BELLINGHAM
Mailing Address - State:WA
Mailing Address - Zip Code:98225-7063
Mailing Address - Country:US
Mailing Address - Phone:360-927-5466
Mailing Address - Fax:
Practice Address - Street 1:1210 10TH ST
Practice Address - Street 2:201
Practice Address - City:BELLINGHAM
Practice Address - State:WA
Practice Address - Zip Code:98225-7063
Practice Address - Country:US
Practice Address - Phone:360-927-5466
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-10
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMA00015989225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist