Provider Demographics
NPI:1861647679
Name:NATOLI, ANTONIA MARIA (LMP)
Entity Type:Individual
Prefix:
First Name:ANTONIA
Middle Name:MARIA
Last Name:NATOLI
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 1:1122 NE 130TH ST
Mailing Address - Street 2:
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98125-4099
Mailing Address - Country:US
Mailing Address - Phone:206-368-8263
Mailing Address - Fax:
Practice Address - Street 1:1122 NE 130TH ST
Practice Address - Street 2:
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98125-4099
Practice Address - Country:US
Practice Address - Phone:206-368-8263
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-11-20
Last Update Date:2008-11-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMA00006162172M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes172M00000XOther Service ProvidersMechanotherapist