Provider Demographics
NPI:1134453087
Name:HOWARTH, STASHA A (LMP)
Entity type:Individual
Prefix:MS
First Name:STASHA
Middle Name:A
Last Name:HOWARTH
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:PO BOX 785
Mailing Address - Street 2:
Mailing Address - City:LAKE STEVENS
Mailing Address - State:WA
Mailing Address - Zip Code:98258-0785
Mailing Address - Country:US
Mailing Address - Phone:425-346-7406
Mailing Address - Fax:
Practice Address - Street 1:9633 MARKET PL
Practice Address - Street 2:SUITE 103
Practice Address - City:LAKE STEVENS
Practice Address - State:WA
Practice Address - Zip Code:98258-7944
Practice Address - Country:US
Practice Address - Phone:425-346-7406
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-09-24
Last Update Date:2009-09-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMA00022536225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist