Provider Demographics
NPI:1801059910
Name:PAREDES, RHONDA (LMP)
Entity type:Individual
Prefix:MS
First Name:RHONDA
Middle Name:
Last Name:PAREDES
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 1:4212 JOHN DEERE LN
Mailing Address - Street 2:
Mailing Address - City:PASCO
Mailing Address - State:WA
Mailing Address - Zip Code:99301-9146
Mailing Address - Country:US
Mailing Address - Phone:509-438-1523
Mailing Address - Fax:
Practice Address - Street 1:2640 W BRUNEAU PL
Practice Address - Street 2:
Practice Address - City:KENNEWICK
Practice Address - State:WA
Practice Address - Zip Code:99336-3134
Practice Address - Country:US
Practice Address - Phone:509-783-2949
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-07-08
Last Update Date:2008-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMA 60019047225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
WAMA 60019047OtherWA STATE DEPARTMENT OF HEALTH MASSAGE PRACTITIONER LISENCE