Provider Demographics
NPI:1922396175
Name:THOMAS, NADIA LIZZIE (LMP)
Entity Type:Individual
Prefix:MS
First Name:NADIA
Middle Name:LIZZIE
Last Name:THOMAS
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 1:3312 AUBURN WAY S STE G
Mailing Address - Street 2:
Mailing Address - City:AUBURN
Mailing Address - State:WA
Mailing Address - Zip Code:98092-6259
Mailing Address - Country:US
Mailing Address - Phone:253-833-3990
Mailing Address - Fax:253-833-3993
Practice Address - Street 1:3312 AUBURN WAY S STE G
Practice Address - Street 2:
Practice Address - City:AUBURN
Practice Address - State:WA
Practice Address - Zip Code:98092-6259
Practice Address - Country:US
Practice Address - Phone:253-833-3990
Practice Address - Fax:253-833-3993
Is Sole Proprietor?:No
Enumeration Date:2011-07-20
Last Update Date:2011-07-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMA00024007225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist