Provider Demographics
NPI:1740490838
Name:DEVNEY, KATHLEEN M (LMP)
Entity type:Individual
Prefix:
First Name:KATHLEEN
Middle Name:M
Last Name:DEVNEY
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 1:12313 60TH ST SE
Mailing Address - Street 2:
Mailing Address - City:SNOHOMISH
Mailing Address - State:WA
Mailing Address - Zip Code:98290-9408
Mailing Address - Country:US
Mailing Address - Phone:425-418-8944
Mailing Address - Fax:
Practice Address - Street 1:12313 60TH ST SE
Practice Address - Street 2:
Practice Address - City:SNOHOMISH
Practice Address - State:WA
Practice Address - Zip Code:98290-9408
Practice Address - Country:US
Practice Address - Phone:425-418-8944
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-23
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMA00014368172M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes172M00000XOther Service ProvidersMechanotherapist