Provider Demographics
NPI:1043402860
Name:OLEJKO, MARIE PATTY (LMP LICENSED MASSAGE)
Entity type:Individual
Prefix:MS
First Name:MARIE
Middle Name:PATTY
Last Name:OLEJKO
Suffix:
Gender:F
Credentials:LMP LICENSED MASSAGE
Other - Prefix:MS
Other - First Name:MARIE
Other - Middle Name:PATTY
Other - Last Name:GLINKA
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:12734 NE 116TH LN
Mailing Address - Street 2:G-2
Mailing Address - City:KIRKLAND
Mailing Address - State:WA
Mailing Address - Zip Code:98034-8474
Mailing Address - Country:US
Mailing Address - Phone:425-890-3985
Mailing Address - Fax:
Practice Address - Street 1:12734 NE 116TH LN
Practice Address - Street 2:G-2
Practice Address - City:KIRKLAND
Practice Address - State:WA
Practice Address - Zip Code:98034-8474
Practice Address - Country:US
Practice Address - Phone:425-890-3985
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-08-15
Last Update Date:2007-08-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WALP00038529164W00000X
WAMA00009481225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist
No164W00000XNursing Service ProvidersLicensed Practical Nurse