Provider Demographics
NPI:1053815514
Name:SAMUELSEN, ANNIKA (LMT)
Entity type:Individual
Prefix:MS
First Name:ANNIKA
Middle Name:
Last Name:SAMUELSEN
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 1:21027 22ND AVE W
Mailing Address - Street 2:
Mailing Address - City:LYNNWOOD
Mailing Address - State:WA
Mailing Address - Zip Code:98036-7954
Mailing Address - Country:US
Mailing Address - Phone:425-241-1071
Mailing Address - Fax:
Practice Address - Street 1:144 RAILROAD AVE STE 205
Practice Address - Street 2:
Practice Address - City:EDMONDS
Practice Address - State:WA
Practice Address - Zip Code:98020-4121
Practice Address - Country:US
Practice Address - Phone:425-245-4257
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-03-20
Last Update Date:2022-12-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist