Provider Demographics
NPI:1922470129
Name:SINGH, AMY BETH (LMT)
Entity Type:Individual
Prefix:MS
First Name:AMY
Middle Name:BETH
Last Name:SINGH
Suffix:
Gender:F
Credentials:LMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:701 WINSLOW WAY E STE B
Mailing Address - Street 2:
Mailing Address - City:BAINBRIDGE ISLAND
Mailing Address - State:WA
Mailing Address - Zip Code:98110-2416
Mailing Address - Country:US
Mailing Address - Phone:206-842-2690
Mailing Address - Fax:
Practice Address - Street 1:701 WINSLOW WAY E STE B
Practice Address - Street 2:
Practice Address - City:BAINBRIDGE ISLAND
Practice Address - State:WA
Practice Address - Zip Code:98110-2416
Practice Address - Country:US
Practice Address - Phone:206-842-2690
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-10-27
Last Update Date:2015-10-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMA60599790225700000X
OR21379225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
WAMA60599790OtherWASHINGTON STATE DEPARTMENT OF HEALTH
OR21379OtherOREGON STATE BOARD OF MASSAGE