Provider Demographics
NPI:1174708051
Name:DANIELS, MALYNDA CHARLOTTE (LMP)
Entity type:Individual
Prefix:
First Name:MALYNDA
Middle Name:CHARLOTTE
Last Name:DANIELS
Suffix:
Gender:F
Credentials:LMP
Other - Prefix:
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Other - Credentials:
Mailing Address - Street 1:4220 132ND ST SE
Mailing Address - Street 2:SUITE 101
Mailing Address - City:MILL CREEK
Mailing Address - State:WA
Mailing Address - Zip Code:98012-8999
Mailing Address - Country:US
Mailing Address - Phone:425-357-9380
Mailing Address - Fax:425-357-9382
Practice Address - Street 1:919 STATE AVE
Practice Address - Street 2:SUITE 101
Practice Address - City:MARYSVILLE
Practice Address - State:WA
Practice Address - Zip Code:98270-4284
Practice Address - Country:US
Practice Address - Phone:360-386-7405
Practice Address - Fax:360-386-7406
Is Sole Proprietor?:Yes
Enumeration Date:2008-01-09
Last Update Date:2017-02-21
Deactivation Date:
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Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist