Provider Demographics
NPI:1861536401
Name:SALO, AARON MATTHEW (LMP)
Entity type:Individual
Prefix:
First Name:AARON
Middle Name:MATTHEW
Last Name:SALO
Suffix:
Gender:M
Credentials:LMP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1138 NW MARKET ST
Mailing Address - Street 2:
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98107-3710
Mailing Address - Country:US
Mailing Address - Phone:206-783-0404
Mailing Address - Fax:206-782-8955
Practice Address - Street 1:1138 NW MARKET ST
Practice Address - Street 2:
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98107-3710
Practice Address - Country:US
Practice Address - Phone:206-783-0404
Practice Address - Fax:206-782-8955
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-16
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMA00004679225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist