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NPI Code Detail

MEDICARE: REBECCA JEAN MOORMAN LMP

MEDICARE: REBECCA JEAN MOORMAN LMP
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1225700000XMassage TherapistMA60299284WA

General Provider Information

NPI Number : 1053741306
Entity Type Code : Individual
Provider Name (Legal Business Name) : REBECCA JEAN MOORMAN LMP
Provider Business Mailing Address
First Line : 1426 NW 61ST ST APT 4
Second Line :
City : SEATTLE
State : WA
Zip : 98107-2959
Country : US
Telephone Number : 206-280-1027
Fax Number :
Provider Business Practice Location Address
First Line : 2821 NW MARKET ST STE E
Second Line :
City : SEATTLE
State : WA
Zip : 98107-5815
Country : US
Telephone Number : 206-706-0063
Fax Number : 206-580-1205
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 11/23/2013
Last Update Date : 11/23/2013

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Directions to “ REBECCA JEAN MOORMAN LMP” Practice Location

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