Lake, Crystal Ann
Lake, Crystal Ann is an individual health care provider with primary practice located at 5814 Graham Ave Ste 101 , Sumner WA 98390-2728. She recently has only one registered license in Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Massage Therapist, which is considered as her primary health care specialty. Lake, Crystal Ann can be contacted via phone (253) 891-7093.Contact Information
Primary practice address
5814 Graham Ave Ste 101
Sumner WA 98390-2728
Phone: (253) 891-7093
Fax: (951) 973-7216
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Massage Therapist | 225700000X | MA60879902 | Washington |
Profile Details
| NPI number | 1508344383 |
|---|---|
| LBN Legal business name | Lake, Crystal Ann |
| Credentials | LMT |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Aug 2nd, 2018 |
| Last updated | Aug 2nd, 2018 - about 8 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1508344383 | NPPES |
| Washington | Other | MA60879902 | MASSAGE THERAPY LICENSE |
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