Provider Demographics
NPI:1679708820
Name:FEIKEMA, WILLIAM PETER (LMP)
Entity type:Individual
Prefix:MR
First Name:WILLIAM
Middle Name:PETER
Last Name:FEIKEMA
Suffix:
Gender:M
Credentials:LMP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:903 MILLS PL NE
Mailing Address - Street 2:
Mailing Address - City:NORTH BEND
Mailing Address - State:WA
Mailing Address - Zip Code:98045-8977
Mailing Address - Country:US
Mailing Address - Phone:425-831-8890
Mailing Address - Fax:
Practice Address - Street 1:325 BENDIGO BLVD N
Practice Address - Street 2:
Practice Address - City:NORTH BEND
Practice Address - State:WA
Practice Address - Zip Code:98045-8260
Practice Address - Country:US
Practice Address - Phone:425-736-9674
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-05-18
Last Update Date:2016-11-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMA 60064539225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist