Provider Demographics
NPI:1619868700
Name:LEWIS, ASHLEY MARIE (LMT)
Entity type:Individual
Prefix:
First Name:ASHLEY
Middle Name:MARIE
Last Name:LEWIS
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 1:6667 N HARRIS HAWK LN
Mailing Address - Street 2:
Mailing Address - City:COEUR D ALENE
Mailing Address - State:ID
Mailing Address - Zip Code:83815-5097
Mailing Address - Country:US
Mailing Address - Phone:509-760-5155
Mailing Address - Fax:
Practice Address - Street 1:1224 N IDAHO ST STE 10
Practice Address - Street 2:
Practice Address - City:POST FALLS
Practice Address - State:ID
Practice Address - Zip Code:83854-9024
Practice Address - Country:US
Practice Address - Phone:509-232-8955
Practice Address - Fax:509-232-8955
Is Sole Proprietor?:No
Enumeration Date:2025-07-15
Last Update Date:2025-07-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ID367664225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist