Provider Demographics
NPI:1548480767
Name:PMD HEALTH INC
Entity type:Organization
Organization Name:PMD HEALTH INC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:LICENSED MASSAGE PRACTITIONER VP
Authorized Official - Prefix:
Authorized Official - First Name:MARY
Authorized Official - Middle Name:W
Authorized Official - Last Name:LUKENS DOMPE
Authorized Official - Suffix:
Authorized Official - Credentials:LMP
Authorized Official - Phone:206-816-3433
Mailing Address - Street 1:1904 3RD AVE
Mailing Address - Street 2:#808
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98101
Mailing Address - Country:US
Mailing Address - Phone:206-816-3433
Mailing Address - Fax:206-816-3423
Practice Address - Street 1:1904 3RD AVE
Practice Address - Street 2:#808
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98101
Practice Address - Country:US
Practice Address - Phone:206-816-3433
Practice Address - Fax:206-816-3423
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-30
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMA00008605225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage TherapistGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA203835OtherLABOR & INDUSTRIES