Provider Demographics
NPI:1720313208
Name:GREER, KENDA MARIE (LMP)
Entity Type:Individual
Prefix:MRS
First Name:KENDA
Middle Name:MARIE
Last Name:GREER
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 1:1305 S 312TH ST
Mailing Address - Street 2:SUITE 202
Mailing Address - City:FEDERAL WAY
Mailing Address - State:WA
Mailing Address - Zip Code:98003-9028
Mailing Address - Country:US
Mailing Address - Phone:243-946-2000
Mailing Address - Fax:
Practice Address - Street 1:1305 S 312TH ST
Practice Address - Street 2:SUITE 202
Practice Address - City:FEDERAL WAY
Practice Address - State:WA
Practice Address - Zip Code:98003-9028
Practice Address - Country:US
Practice Address - Phone:243-946-2000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-10-16
Last Update Date:2009-10-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMA60042708225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist