Provider Demographics
NPI:1013137983
Name:SILVERMAN, SOFE (LMP)
Entity Type:Individual
Prefix:MRS
First Name:SOFE
Middle Name:
Last Name:SILVERMAN
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 1:8636 ONYX DR SW UNIT A
Mailing Address - Street 2:
Mailing Address - City:LAKEWOOD
Mailing Address - State:WA
Mailing Address - Zip Code:98498-4868
Mailing Address - Country:US
Mailing Address - Phone:253-756-8993
Mailing Address - Fax:
Practice Address - Street 1:7406 27TH ST W
Practice Address - Street 2:#24A
Practice Address - City:UNIVERSITY PLACE
Practice Address - State:WA
Practice Address - Zip Code:98466-4632
Practice Address - Country:US
Practice Address - Phone:253-756-8993
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-26
Last Update Date:2009-08-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMA00016009225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
WAMA00016009OtherWA STATE MASSAGE LICENSE