Provider Demographics
NPI:1205177110
Name:KRAKOWIAK, LUCY (LMP)
Entity type:Individual
Prefix:MS
First Name:LUCY
Middle Name:
Last Name:KRAKOWIAK
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 66852
Mailing Address - Street 2:
Mailing Address - City:BURIEN
Mailing Address - State:WA
Mailing Address - Zip Code:98166-0852
Mailing Address - Country:US
Mailing Address - Phone:206-244-1952
Mailing Address - Fax:
Practice Address - Street 1:15858 - 1ST AVE SOUTH
Practice Address - Street 2:STE A104
Practice Address - City:BURIEN
Practice Address - State:WA
Practice Address - Zip Code:98148
Practice Address - Country:US
Practice Address - Phone:206-838-0022
Practice Address - Fax:206-838-0021
Is Sole Proprietor?:Yes
Enumeration Date:2013-03-04
Last Update Date:2013-03-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMA00007457225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist