Provider Demographics
NPI:1730321308
Name:BARNARD, SAMANTHA JANE (LMP)
Entity type:Individual
Prefix:MS
First Name:SAMANTHA
Middle Name:JANE
Last Name:BARNARD
Suffix:
Gender:F
Credentials:LMP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 2877
Mailing Address - Street 2:
Mailing Address - City:WOODINVILLE
Mailing Address - State:WA
Mailing Address - Zip Code:98072-2877
Mailing Address - Country:US
Mailing Address - Phone:206-817-8208
Mailing Address - Fax:
Practice Address - Street 1:413 14TH AVE W
Practice Address - Street 2:
Practice Address - City:KIRKLAND
Practice Address - State:WA
Practice Address - Zip Code:98033-5310
Practice Address - Country:US
Practice Address - Phone:206-817-8208
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-03-29
Last Update Date:2009-03-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMA 00018984225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist