Provider Demographics
NPI:1679608889
Name:ALLEN, GAIL ANN (LMP)
Entity type:Individual
Prefix:MS
First Name:GAIL
Middle Name:ANN
Last Name:ALLEN
Suffix:
Gender:F
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:PO BOX 2999
Mailing Address - Street 2:
Mailing Address - City:ARLINGTON
Mailing Address - State:WA
Mailing Address - Zip Code:98223-2901
Mailing Address - Country:US
Mailing Address - Phone:360-657-4810
Mailing Address - Fax:360-657-4817
Practice Address - Street 1:18725 SMOKEY POINT BLVD
Practice Address - Street 2:
Practice Address - City:ARLINGTON
Practice Address - State:WA
Practice Address - Zip Code:98223-8713
Practice Address - Country:US
Practice Address - Phone:360-657-4810
Practice Address - Fax:360-657-4817
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-21
Last Update Date:2010-02-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMA00021290225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist