Provider Demographics
NPI:1669955118
Name:PALMER, CATHERINE MARIE (LMT)
Entity type:Individual
Prefix:
First Name:CATHERINE
Middle Name:MARIE
Last Name:PALMER
Suffix:
Gender:F
Credentials:LMT
Other - Prefix:
Other - First Name:CATHERINE
Other - Middle Name:MARIE
Other - Last Name:OOSTING
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:9361 N BLUE FOX DR
Mailing Address - Street 2:
Mailing Address - City:PALMER
Mailing Address - State:AK
Mailing Address - Zip Code:99645-9268
Mailing Address - Country:US
Mailing Address - Phone:907-354-7318
Mailing Address - Fax:
Practice Address - Street 1:9361 N BLUE FOX DR
Practice Address - Street 2:
Practice Address - City:PALMER
Practice Address - State:AK
Practice Address - Zip Code:99645-9268
Practice Address - Country:US
Practice Address - Phone:907-354-7318
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-09-11
Last Update Date:2018-09-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AK121214225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist