Provider Demographics
NPI:1942563580
Name:SIMKINS, STEVEN W (LMP)
Entity Type:Individual
Prefix:MR
First Name:STEVEN
Middle Name:W
Last Name:SIMKINS
Suffix:
Gender:M
Credentials:LMP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7406 27TH ST W
Mailing Address - Street 2:STE. 23
Mailing Address - City:UNIVERSITY PLACE
Mailing Address - State:WA
Mailing Address - Zip Code:98466-4632
Mailing Address - Country:US
Mailing Address - Phone:253-564-4284
Mailing Address - Fax:
Practice Address - Street 1:7406 27TH ST W
Practice Address - Street 2:STE. 23
Practice Address - City:UNIVERSITY PLACE
Practice Address - State:WA
Practice Address - Zip Code:98466-4632
Practice Address - Country:US
Practice Address - Phone:253-564-4284
Practice Address - Fax:253-564-4284
Is Sole Proprietor?:Yes
Enumeration Date:2012-06-19
Last Update Date:2012-06-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMA60195176225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist