Provider Demographics
NPI:1013385590
Name:POSTLEWAITE, JOHN (LMP)
Entity Type:Individual
Prefix:
First Name:JOHN
Middle Name:
Last Name:POSTLEWAITE
Suffix:
Gender:M
Credentials:LMP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:20915 NE 44TH ST
Mailing Address - Street 2:
Mailing Address - City:SAMMAMISH
Mailing Address - State:WA
Mailing Address - Zip Code:98074-9349
Mailing Address - Country:US
Mailing Address - Phone:425-681-7017
Mailing Address - Fax:
Practice Address - Street 1:20915 NE 44TH ST
Practice Address - Street 2:
Practice Address - City:SAMMAMISH
Practice Address - State:WA
Practice Address - Zip Code:98074-9349
Practice Address - Country:US
Practice Address - Phone:425-681-7017
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-09-14
Last Update Date:2015-09-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMA 60579464225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist