Provider Demographics
NPI:1043374150
Name:RODRIGUEZ, ALETHIA (LMP)
Entity type:Individual
Prefix:MS
First Name:ALETHIA
Middle Name:
Last Name:RODRIGUEZ
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 1:10700 SE 208TH ST STE 207
Mailing Address - Street 2:
Mailing Address - City:KENT
Mailing Address - State:WA
Mailing Address - Zip Code:98031-5545
Mailing Address - Country:US
Mailing Address - Phone:253-854-3185
Mailing Address - Fax:
Practice Address - Street 1:10700 SE 208TH ST STE 207
Practice Address - Street 2:
Practice Address - City:KENT
Practice Address - State:WA
Practice Address - Zip Code:98031-5545
Practice Address - Country:US
Practice Address - Phone:253-854-3185
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-21
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMA00010542225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA0213824OtherDEPARTMENT OF L&I