Provider Demographics
NPI:1861569899
Name:ABBOTT, KAREN ANN (LMP)
Entity type:Individual
Prefix:MS
First Name:KAREN
Middle Name:ANN
Last Name:ABBOTT
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 1:5157 BOUNTY LOOP
Mailing Address - Street 2:
Mailing Address - City:FREELAND
Mailing Address - State:WA
Mailing Address - Zip Code:98249-9627
Mailing Address - Country:US
Mailing Address - Phone:206-412-4897
Mailing Address - Fax:
Practice Address - Street 1:1832 SCOTT RD STE C6
Practice Address - Street 2:
Practice Address - City:FREELAND
Practice Address - State:WA
Practice Address - Zip Code:98249-9475
Practice Address - Country:US
Practice Address - Phone:206-412-4897
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-28
Last Update Date:2025-06-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMA00012064225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA601903301OtherUBI #