Provider Demographics
NPI:1356741680
Name:ELLIOTT, KARI (LMP, NTP)
Entity type:Individual
Prefix:
First Name:KARI
Middle Name:
Last Name:ELLIOTT
Suffix:
Gender:F
Credentials:LMP, NTP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6814 A ST
Mailing Address - Street 2:
Mailing Address - City:TACOMA
Mailing Address - State:WA
Mailing Address - Zip Code:98408-7203
Mailing Address - Country:US
Mailing Address - Phone:206-713-2298
Mailing Address - Fax:253-475-9270
Practice Address - Street 1:6814 A ST
Practice Address - Street 2:
Practice Address - City:TACOMA
Practice Address - State:WA
Practice Address - Zip Code:98408-7203
Practice Address - Country:US
Practice Address - Phone:206-713-2298
Practice Address - Fax:253-475-9270
Is Sole Proprietor?:Yes
Enumeration Date:2014-08-22
Last Update Date:2014-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMA00003277225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist