Provider Demographics
NPI:1578939666
Name:MCMAHON, ERICA LEE (LMT)
Entity type:Individual
Prefix:MS
First Name:ERICA
Middle Name:LEE
Last Name:MCMAHON
Suffix:
Gender:F
Credentials:LMT
Other - Prefix:MS
Other - First Name:ERICA
Other - Middle Name:LEE
Other - Last Name:ENEGREN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LMT
Mailing Address - Street 1:17627 83RD PL. NE
Mailing Address - Street 2:
Mailing Address - City:KENMORE
Mailing Address - State:WA
Mailing Address - Zip Code:98028
Mailing Address - Country:US
Mailing Address - Phone:360-333-5291
Mailing Address - Fax:
Practice Address - Street 1:17627 83RD PL. NE
Practice Address - Street 2:
Practice Address - City:KENMORE
Practice Address - State:WA
Practice Address - Zip Code:98028
Practice Address - Country:US
Practice Address - Phone:360-333-5291
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-08-12
Last Update Date:2025-05-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMA 60548936225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist