Provider Demographics
NPI:1831319763
Name:VANWAMBECK, CYNTHIA JUNE (LMP)
Entity Type:Individual
Prefix:MRS
First Name:CYNTHIA
Middle Name:JUNE
Last Name:VANWAMBECK
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 1:2426 231ST PL NE
Mailing Address - Street 2:
Mailing Address - City:SAMMAMISH
Mailing Address - State:WA
Mailing Address - Zip Code:98074-6530
Mailing Address - Country:US
Mailing Address - Phone:206-601-4307
Mailing Address - Fax:425-836-4662
Practice Address - Street 1:2426 231ST PL NE
Practice Address - Street 2:
Practice Address - City:SAMMAMISH
Practice Address - State:WA
Practice Address - Zip Code:98074-6530
Practice Address - Country:US
Practice Address - Phone:206-601-4307
Practice Address - Fax:425-836-4662
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-25
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMA00015018225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist