Provider Demographics
NPI:1922254143
Name:SWISHER, LANNAYA A (LMP)
Entity Type:Individual
Prefix:
First Name:LANNAYA
Middle Name:A
Last Name:SWISHER
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 1:16915 SE 272ND ST
Mailing Address - Street 2:100-123
Mailing Address - City:COVINGTON
Mailing Address - State:WA
Mailing Address - Zip Code:98042-7347
Mailing Address - Country:US
Mailing Address - Phone:253-797-8425
Mailing Address - Fax:
Practice Address - Street 1:15220 SE 272ND ST
Practice Address - Street 2:SUITE G
Practice Address - City:KENT
Practice Address - State:WA
Practice Address - Zip Code:98042-4241
Practice Address - Country:US
Practice Address - Phone:253-630-6768
Practice Address - Fax:253-630-6639
Is Sole Proprietor?:Yes
Enumeration Date:2008-08-08
Last Update Date:2008-08-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMA00016875225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist