Provider Demographics
NPI:1881802130
Name:THOMPSON, SUNNY ELLIOTT (LMP)
Entity type:Individual
Prefix:
First Name:SUNNY
Middle Name:ELLIOTT
Last Name:THOMPSON
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 1:54922 KERNAHAN RD E
Mailing Address - Street 2:
Mailing Address - City:ASHFORD
Mailing Address - State:WA
Mailing Address - Zip Code:98304-9761
Mailing Address - Country:US
Mailing Address - Phone:360-569-2285
Mailing Address - Fax:360-569-0841
Practice Address - Street 1:54922 KERNAHAN RD E
Practice Address - Street 2:
Practice Address - City:ASHFORD
Practice Address - State:WA
Practice Address - Zip Code:98304-9761
Practice Address - Country:US
Practice Address - Phone:360-569-2285
Practice Address - Fax:360-569-0841
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-18
Last Update Date:2011-02-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist