Provider Demographics
NPI:1740451442
Name:MORROW, MIKI (LMT)
Entity type:Individual
Prefix:
First Name:MIKI
Middle Name:
Last Name:MORROW
Suffix:
Gender:F
Credentials:LMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 874104
Mailing Address - Street 2:
Mailing Address - City:VANCOUVER
Mailing Address - State:WA
Mailing Address - Zip Code:98687-4104
Mailing Address - Country:US
Mailing Address - Phone:989-829-3403
Mailing Address - Fax:
Practice Address - Street 1:415 SE 177TH AVE
Practice Address - Street 2:
Practice Address - City:VANCOUVER
Practice Address - State:WA
Practice Address - Zip Code:98683-4201
Practice Address - Country:US
Practice Address - Phone:360-608-0135
Practice Address - Fax:360-208-0241
Is Sole Proprietor?:Yes
Enumeration Date:2008-03-20
Last Update Date:2023-02-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMA00025265225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist