Provider Demographics
NPI:1760296834
Name:MAZZEI, MALIA (LMT, CCST)
Entity type:Individual
Prefix:
First Name:MALIA
Middle Name:
Last Name:MAZZEI
Suffix:
Gender:F
Credentials:LMT, CCST
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1311 12TH AVE S APT B302
Mailing Address - Street 2:
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98144-3469
Mailing Address - Country:US
Mailing Address - Phone:425-591-3993
Mailing Address - Fax:
Practice Address - Street 1:1940 116TH AVE NE STE 102
Practice Address - Street 2:
Practice Address - City:BELLEVUE
Practice Address - State:WA
Practice Address - Zip Code:98004-3011
Practice Address - Country:US
Practice Address - Phone:425-591-3993
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-02-06
Last Update Date:2025-02-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMA60960174225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist