Provider Demographics
NPI:1992868301
Name:WILLIAMS, TAMMIE ELIZABETH (LMP)
Entity Type:Individual
Prefix:MRS
First Name:TAMMIE
Middle Name:ELIZABETH
Last Name:WILLIAMS
Suffix:
Gender:F
Credentials:LMP
Other - Prefix:MRS
Other - First Name:TAMMIE
Other - Middle Name:ELIZABETH
Other - Last Name:WOOLARD
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:LMP
Mailing Address - Street 1:3517 S 263RD ST
Mailing Address - Street 2:
Mailing Address - City:KENT
Mailing Address - State:WA
Mailing Address - Zip Code:98032-7041
Mailing Address - Country:US
Mailing Address - Phone:253-520-9454
Mailing Address - Fax:
Practice Address - Street 1:9015 HOLMAN RD NW STE 3
Practice Address - Street 2:
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98117-3481
Practice Address - Country:US
Practice Address - Phone:206-782-8500
Practice Address - Fax:206-784-4020
Is Sole Proprietor?:No
Enumeration Date:2006-12-18
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMA00017258225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA0007842488OtherAETNA INSURANCE COMPANY