Provider Demographics
NPI:1114180627
Name:PETERS, DEBYE LYNN (LMP, REIKI MASTER)
Entity type:Individual
Prefix:
First Name:DEBYE
Middle Name:LYNN
Last Name:PETERS
Suffix:
Gender:F
Credentials:LMP, REIKI MASTER
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:30110 127TH PL SE
Mailing Address - Street 2:
Mailing Address - City:AUBURN
Mailing Address - State:WA
Mailing Address - Zip Code:98092-2147
Mailing Address - Country:US
Mailing Address - Phone:253-709-1964
Mailing Address - Fax:253-269-4277
Practice Address - Street 1:26461 104TH AVE SE
Practice Address - Street 2:
Practice Address - City:KENT
Practice Address - State:WA
Practice Address - Zip Code:98030-7668
Practice Address - Country:US
Practice Address - Phone:253-709-1964
Practice Address - Fax:253-269-4277
Is Sole Proprietor?:Yes
Enumeration Date:2008-07-03
Last Update Date:2008-07-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMA0018861225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist