Gedevanishvili, Mariam

Gedevanishvili, Mariam is an sole proprietor health care provider with primary practice located at 10700 Se 208Th St Ste 207 , Kent WA 98031-5545. She recently has 3 registered licenses in different health care specialties including Dietary & Nutritional Service Providers / Nutrition, Education, Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Athletic Trainer, Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Massage Therapist. Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Massage Therapist is her primary health care specialty. Gedevanishvili, Mariam can be contacted via phone (206) 755-1758.

Contact Information

Primary practice address
10700 Se 208Th St Ste 207 Kent WA 98031-5545
Phone: (206) 755-1758
Fax: (253) 833-2686
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Dietary & Nutritional Service Providers / Nutrition, Education 133NN1002X
Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Athletic Trainer 2255A2300X
Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Massage Therapist 225700000X MA60058598 Washington

Profile Details

NPI number 1083778104
LBN Legal business name Gedevanishvili, Mariam
Credentials
Entity Individual
Sole proprietor 1 Yes
Enumeration date Dec 21st, 2006
Last updated Jun 11th, 2012 - about 12 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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