Basic Information
Provider Information
NPI: 1124635693
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: AALTONEN
FirstName: ARJA
MiddleName: K
NamePrefix:  
NameSuffix:  
Credential: LMT
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 1560 3RD AVE
Address2:  
City: LONGVIEW
State: WA
PostalCode: 986323229
CountryCode: US
TelephoneNumber: 5034108876
FaxNumber:  
Practice Location
Address1: 1560 3RD AVE
Address2:  
City: LONGVIEW
State: WA
PostalCode: 986323229
CountryCode: US
TelephoneNumber: 3604239535
FaxNumber: 3604149284
Other Information
ProviderEnumerationDate: 09/28/2020
LastUpdateDate: 09/28/2020
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate: 09/28/2020

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
225700000XMA60250635WAY Respiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist 

No ID Information.


Home