Provider Demographics
NPI:1538396783
Name:BOWEN, ASHLEY M (LMP)
Entity type:Individual
Prefix:
First Name:ASHLEY
Middle Name:M
Last Name:BOWEN
Suffix:
Gender:F
Credentials:LMP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:1917 W 19TH AVE
Mailing Address - Street 2:
Mailing Address - City:KENNEWICK
Mailing Address - State:WA
Mailing Address - Zip Code:99337-3516
Mailing Address - Country:US
Mailing Address - Phone:509-628-7704
Mailing Address - Fax:509-946-4422
Practice Address - Street 1:712 SWIFT BLVD
Practice Address - Street 2:SUITE 3B
Practice Address - City:RICHLAND
Practice Address - State:WA
Practice Address - Zip Code:99352-3578
Practice Address - Country:US
Practice Address - Phone:509-628-7704
Practice Address - Fax:509-946-4422
Is Sole Proprietor?:Yes
Enumeration Date:2009-06-15
Last Update Date:2009-06-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMA60083543172M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes172M00000XOther Service ProvidersMechanotherapist