Provider Demographics
NPI:1942611686
Name:KRAMER, NADINE SHELLI (LMP)
Entity Type:Individual
Prefix:
First Name:NADINE
Middle Name:SHELLI
Last Name:KRAMER
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 1:3803 E WILDING AVE
Mailing Address - Street 2:
Mailing Address - City:SPOKANE
Mailing Address - State:WA
Mailing Address - Zip Code:99217-7933
Mailing Address - Country:US
Mailing Address - Phone:509-315-5612
Mailing Address - Fax:
Practice Address - Street 1:3803 E WILDING AVE
Practice Address - Street 2:
Practice Address - City:SPOKANE
Practice Address - State:WA
Practice Address - Zip Code:99217-7933
Practice Address - Country:US
Practice Address - Phone:509-315-5612
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-05-15
Last Update Date:2014-05-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA00020767225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist