Provider Demographics
NPI:1881909737
Name:BRONSON, KAREN (RN, LMP)
Entity type:Individual
Prefix:MRS
First Name:KAREN
Middle Name:
Last Name:BRONSON
Suffix:
Gender:F
Credentials:RN, LMP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1921 237TH PL SE
Mailing Address - Street 2:
Mailing Address - City:BOTHELL
Mailing Address - State:WA
Mailing Address - Zip Code:98021-9642
Mailing Address - Country:US
Mailing Address - Phone:206-890-4882
Mailing Address - Fax:
Practice Address - Street 1:15118 MAIN ST STE 500
Practice Address - Street 2:
Practice Address - City:MILL CREEK
Practice Address - State:WA
Practice Address - Zip Code:98012-1653
Practice Address - Country:US
Practice Address - Phone:206-890-4882
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-08-16
Last Update Date:2010-08-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WARN0090678163WM1400X
WAMA60178063225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WM1400XNursing Service ProvidersRegistered NurseNurse Massage Therapist (NMT)
No225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist