Provider Demographics
NPI:1952601916
Name:ESPINOSA, ANN MILLIRON (LMP)
Entity Type:Individual
Prefix:MRS
First Name:ANN
Middle Name:MILLIRON
Last Name:ESPINOSA
Suffix:
Gender:F
Credentials:LMP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:3216 NE 45TH PALCE
Mailing Address - Street 2:#117
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98105
Mailing Address - Country:US
Mailing Address - Phone:425-954-7404
Mailing Address - Fax:206-641-7596
Practice Address - Street 1:3216 NE 45TH PLACE
Practice Address - Street 2:#117
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98105
Practice Address - Country:US
Practice Address - Phone:425-954-7404
Practice Address - Fax:206-641-7596
Is Sole Proprietor?:Yes
Enumeration Date:2010-10-25
Last Update Date:2015-08-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMA60184192225700000X
WABA MA 60184192225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist