Provider Demographics
NPI:1255220885
Name:PECK, CALM (LMT)
Entity type:Individual
Prefix:
First Name:CALM
Middle Name:
Last Name:PECK
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 1:3701 COLBY AVE
Mailing Address - Street 2:
Mailing Address - City:EVERETT
Mailing Address - State:WA
Mailing Address - Zip Code:98201-4979
Mailing Address - Country:US
Mailing Address - Phone:425-259-3700
Mailing Address - Fax:425-259-4283
Practice Address - Street 1:3701 COLBY AVE
Practice Address - Street 2:
Practice Address - City:EVERETT
Practice Address - State:WA
Practice Address - Zip Code:98201-4979
Practice Address - Country:US
Practice Address - Phone:425-259-3700
Practice Address - Fax:425-259-4283
Is Sole Proprietor?:No
Enumeration Date:2025-06-30
Last Update Date:2025-06-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMA00012648225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist