1427293984 NPI number — ALECIAMARIE NICOLE TOWNSEND LMP

Table of content: ALECIAMARIE NICOLE TOWNSEND LMP (NPI 1427293984)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1427293984 NPI number — ALECIAMARIE NICOLE TOWNSEND LMP

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
TOWNSEND
Provider First Name:
ALECIAMARIE
Provider Middle Name:
NICOLE
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
LMP
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
SMITH
Provider Other First Name:
ALECIAMARIE
Provider Other Middle Name:
NICOLE
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
LMP
Provider Other Last Name Type Code:
1

NPI Number Information

NPI Number:
1427293984
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
03/27/2012
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
33427 PACIFIC HWY. S. #C-1
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
FEDERAL
Provider Business Mailing Address State Name:
WA
Provider Business Mailing Address Postal Code:
98003
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
253-874-2498
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
33427 PACIFIC HWY. S. #C-1
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
FEDERAL
Provider Business Practice Location Address State Name:
WA
Provider Business Practice Location Address Postal Code:
98003
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
253-874-2498
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
12/11/2008

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 225700000X , with the licence number:  MA60044932 , registered in the state of WA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)