Provider Demographics
NPI:1861009243
Name:DESANTIS, LINDA M (LMP)
Entity Type:Individual
Prefix:
First Name:LINDA
Middle Name:M
Last Name:DESANTIS
Suffix:
Gender:F
Credentials:LMP
Other - Prefix:
Other - First Name:LINDA
Other - Middle Name:M
Other - Last Name:LAPPING
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:2315 6TH AVE
Mailing Address - Street 2:
Mailing Address - City:TACOMA
Mailing Address - State:WA
Mailing Address - Zip Code:98403-1050
Mailing Address - Country:US
Mailing Address - Phone:253-564-2220
Mailing Address - Fax:253-564-2221
Practice Address - Street 1:2315 6TH AVE
Practice Address - Street 2:
Practice Address - City:TACOMA
Practice Address - State:WA
Practice Address - Zip Code:98403-1050
Practice Address - Country:US
Practice Address - Phone:253-564-2220
Practice Address - Fax:253-564-2221
Is Sole Proprietor?:Yes
Enumeration Date:2020-09-29
Last Update Date:2020-09-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMA60524236225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage TherapistGroup - Single Specialty