Provider Demographics
NPI:1942594643
Name:STUBBE, KARLEY J (LMT)
Entity Type:Individual
Prefix:
First Name:KARLEY
Middle Name:J
Last Name:STUBBE
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 1:925 5TH ST
Mailing Address - Street 2:SUITE B
Mailing Address - City:WENATCHEE
Mailing Address - State:WA
Mailing Address - Zip Code:98801-1978
Mailing Address - Country:US
Mailing Address - Phone:509-888-4400
Mailing Address - Fax:509-888-2727
Practice Address - Street 1:925 5TH ST
Practice Address - Street 2:SUITE B
Practice Address - City:WENATCHEE
Practice Address - State:WA
Practice Address - Zip Code:98801-1978
Practice Address - Country:US
Practice Address - Phone:509-888-4400
Practice Address - Fax:509-888-2727
Is Sole Proprietor?:No
Enumeration Date:2011-05-31
Last Update Date:2011-05-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMA60224631225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist