Provider Demographics
NPI:1235144684
Name:KEATON, VALARIE ANN (LMP)
Entity type:Individual
Prefix:MS
First Name:VALARIE
Middle Name:ANN
Last Name:KEATON
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 1:14777 NE 40TH ST
Mailing Address - Street 2:#301
Mailing Address - City:BELLEVUE
Mailing Address - State:WA
Mailing Address - Zip Code:98007-3300
Mailing Address - Country:US
Mailing Address - Phone:425-869-1534
Mailing Address - Fax:425-882-8583
Practice Address - Street 1:14777 NE 40TH ST
Practice Address - Street 2:#301
Practice Address - City:BELLEVUE
Practice Address - State:WA
Practice Address - Zip Code:98007-3300
Practice Address - Country:US
Practice Address - Phone:425-869-1534
Practice Address - Fax:425-882-8583
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-31
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMA00007434225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
WACO6377Medicare UPIN