Provider Demographics
NPI:1184143737
Name:SEALOVER, HENLEY LORELEY (LMP)
Entity type:Individual
Prefix:
First Name:HENLEY
Middle Name:LORELEY
Last Name:SEALOVER
Suffix:
Gender:X
Credentials:LMP
Other - Prefix:
Other - First Name:HILORI
Other - Middle Name:
Other - Last Name:DELOE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LMT
Mailing Address - Street 1:8511 S TACOMA WAY # 303
Mailing Address - Street 2:
Mailing Address - City:LAKEWOOD
Mailing Address - State:WA
Mailing Address - Zip Code:98499-6521
Mailing Address - Country:US
Mailing Address - Phone:253-426-1244
Mailing Address - Fax:253-503-7565
Practice Address - Street 1:8511 S TACOMA WAY # 303
Practice Address - Street 2:
Practice Address - City:LAKEWOOD
Practice Address - State:WA
Practice Address - Zip Code:98499-6521
Practice Address - Country:US
Practice Address - Phone:253-426-1244
Practice Address - Fax:253-503-7565
Is Sole Proprietor?:No
Enumeration Date:2017-09-14
Last Update Date:2024-11-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMA60715184225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist