Provider Demographics
NPI:1902246622
Name:BARKER, ALLIE IRENE (LMP)
Entity Type:Individual
Prefix:
First Name:ALLIE
Middle Name:IRENE
Last Name:BARKER
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 1:120 AVENUE A STE C
Mailing Address - Street 2:
Mailing Address - City:SNOHOMISH
Mailing Address - State:WA
Mailing Address - Zip Code:98290-2961
Mailing Address - Country:US
Mailing Address - Phone:360-563-0629
Mailing Address - Fax:360-563-0693
Practice Address - Street 1:120 AVENUE A STE C
Practice Address - Street 2:
Practice Address - City:SNOHOMISH
Practice Address - State:WA
Practice Address - Zip Code:98290-2961
Practice Address - Country:US
Practice Address - Phone:360-563-0629
Practice Address - Fax:360-563-0693
Is Sole Proprietor?:Yes
Enumeration Date:2013-06-26
Last Update Date:2013-06-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMA 60328787172M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes172M00000XOther Service ProvidersMechanotherapist