Provider Demographics
NPI:1861528069
Name:SANTANA, OSMARINA V (LMP)
Entity type:Individual
Prefix:MS
First Name:OSMARINA
Middle Name:V
Last Name:SANTANA
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 1:1151 N 94TH ST APT 37
Mailing Address - Street 2:
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98103-3361
Mailing Address - Country:US
Mailing Address - Phone:206-729-2319
Mailing Address - Fax:
Practice Address - Street 1:4610 200TH ST SW STE N
Practice Address - Street 2:
Practice Address - City:LYNNWOOD
Practice Address - State:WA
Practice Address - Zip Code:98036-6606
Practice Address - Country:US
Practice Address - Phone:425-712-0852
Practice Address - Fax:425-712-9854
Is Sole Proprietor?:No
Enumeration Date:2007-02-24
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMA00006448225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
WAMA00006448OtherLMP