Provider Demographics
NPI:1053525204
Name:FISHER, L. SKYA (LMT)
Entity type:Individual
Prefix:MS
First Name:L.
Middle Name:SKYA
Last Name:FISHER
Suffix:
Gender:F
Credentials:LMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3749 SINCLAIR DR
Mailing Address - Street 2:
Mailing Address - City:FERNDALE
Mailing Address - State:WA
Mailing Address - Zip Code:98248-9524
Mailing Address - Country:US
Mailing Address - Phone:360-383-2287
Mailing Address - Fax:
Practice Address - Street 1:1101 HARRIS AVE
Practice Address - Street 2:
Practice Address - City:BELLINGHAM
Practice Address - State:WA
Practice Address - Zip Code:98225-7062
Practice Address - Country:US
Practice Address - Phone:360-383-2287
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-09
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMA00016751225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist