Provider Demographics
NPI:1700092111
Name:MORTON, SONIA (LMP)
Entity Type:Individual
Prefix:
First Name:SONIA
Middle Name:
Last Name:MORTON
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 1:22501 MARINE VIEW DR S APT 4
Mailing Address - Street 2:
Mailing Address - City:DES MOINES
Mailing Address - State:WA
Mailing Address - Zip Code:98198-6830
Mailing Address - Country:US
Mailing Address - Phone:206-854-5402
Mailing Address - Fax:
Practice Address - Street 1:805 S 219TH ST # A
Practice Address - Street 2:
Practice Address - City:DES MOINES
Practice Address - State:WA
Practice Address - Zip Code:98198-6340
Practice Address - Country:US
Practice Address - Phone:206-878-9355
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-05-15
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMA00015350225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist