Provider Demographics
NPI:1871344580
Name:EICHMAN, EMILYNN (LMT)
Entity type:Individual
Prefix:
First Name:EMILYNN
Middle Name:
Last Name:EICHMAN
Suffix:
Gender:F
Credentials:LMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6046 PORTAL WAY STE 102
Mailing Address - Street 2:
Mailing Address - City:FERNDALE
Mailing Address - State:WA
Mailing Address - Zip Code:98248-7829
Mailing Address - Country:US
Mailing Address - Phone:360-778-1171
Mailing Address - Fax:
Practice Address - Street 1:6046 PORTAL WAY STE 102
Practice Address - Street 2:
Practice Address - City:FERNDALE
Practice Address - State:WA
Practice Address - Zip Code:98248-7829
Practice Address - Country:US
Practice Address - Phone:360-778-1171
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-03-29
Last Update Date:2024-03-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMA61534684225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist