Provider Demographics
NPI:1265751549
Name:ESTES, NATOSHA RAE-ANN
Entity type:Individual
Prefix:
First Name:NATOSHA
Middle Name:RAE-ANN
Last Name:ESTES
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:507 WILLIAMS BLVD NW
Mailing Address - Street 2:
Mailing Address - City:ORTING
Mailing Address - State:WA
Mailing Address - Zip Code:98360-9438
Mailing Address - Country:US
Mailing Address - Phone:253-306-8443
Mailing Address - Fax:
Practice Address - Street 1:507 WILLIAMS BLVD NW
Practice Address - Street 2:
Practice Address - City:ORTING
Practice Address - State:WA
Practice Address - Zip Code:98360-9438
Practice Address - Country:US
Practice Address - Phone:253-306-8443
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-05-25
Last Update Date:2010-05-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMA 60096443225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist