Provider Demographics
NPI:1013119494
Name:HARTWELL, BETTY JANE (LMT)
Entity Type:Individual
Prefix:
First Name:BETTY
Middle Name:JANE
Last Name:HARTWELL
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 1:15511 OK MILL RD
Mailing Address - Street 2:
Mailing Address - City:SNOHOMISH
Mailing Address - State:WA
Mailing Address - Zip Code:98290-7719
Mailing Address - Country:US
Mailing Address - Phone:425-260-0598
Mailing Address - Fax:
Practice Address - Street 1:3310D E LK SAMMAMISH PKWY SE
Practice Address - Street 2:
Practice Address - City:SAMMAMISH
Practice Address - State:WA
Practice Address - Zip Code:98075
Practice Address - Country:US
Practice Address - Phone:425-557-8787
Practice Address - Fax:425-557-6857
Is Sole Proprietor?:No
Enumeration Date:2007-06-05
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA58647225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist