Provider Demographics
NPI:1831552249
Name:ALSWORTH, CINIMIN (MASSAGE THERAPIST)
Entity type:Individual
Prefix:
First Name:CINIMIN
Middle Name:
Last Name:ALSWORTH
Suffix:
Gender:F
Credentials:MASSAGE THERAPIST
Other - Prefix:
Other - First Name:CINIMIN
Other - Middle Name:SEA
Other - Last Name:ALSWORTH
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MASSAGE THERAPIST
Mailing Address - Street 1:3819 W 80TH AVE
Mailing Address - Street 2:
Mailing Address - City:ANCHORAGE
Mailing Address - State:AK
Mailing Address - Zip Code:99502-4330
Mailing Address - Country:US
Mailing Address - Phone:907-223-6390
Mailing Address - Fax:
Practice Address - Street 1:6831 JEWEL LAKE RD
Practice Address - Street 2:
Practice Address - City:ANCHORAGE
Practice Address - State:AK
Practice Address - Zip Code:99502-2823
Practice Address - Country:US
Practice Address - Phone:907-223-6390
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-04-02
Last Update Date:2016-04-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AK101341225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist