Provider Demographics
NPI:1912496456
Name:MCCURDY, LASHANDA (LMT)
Entity Type:Individual
Prefix:
First Name:LASHANDA
Middle Name:
Last Name:MCCURDY
Suffix:
Gender:F
Credentials:LMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:499 FIELD PL NE
Mailing Address - Street 2:
Mailing Address - City:RENTON
Mailing Address - State:WA
Mailing Address - Zip Code:98059-5781
Mailing Address - Country:US
Mailing Address - Phone:425-496-8165
Mailing Address - Fax:
Practice Address - Street 1:401 OLYMPIA AVENUE NE
Practice Address - Street 2:
Practice Address - City:RENTON
Practice Address - State:WA
Practice Address - Zip Code:98056
Practice Address - Country:US
Practice Address - Phone:425-496-8165
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-05-09
Last Update Date:2018-05-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMA60773718225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist