MEDICARE: JACQUELINE VALDEZ LMT

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
1	225700000X	Massage Therapist	MA61001770	WA

General Provider Information

NPI Number	:	1144844408
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JACQUELINE VALDEZ LMT

Provider Business Mailing Address
First Line	:	100 VALLEY MALL PKWY STE 5
Second Line	:
City	:	EAST WENATCHEE
State	:	WA
Zip	:	98802-5348
Country	:	US
Telephone Number	:	509-888-6977
Fax Number	:

Provider Business Practice Location Address
First Line	:	100 VALLEY MALL PKWY STE 5
Second Line	:
City	:	EAST WENATCHEE
State	:	WA
Zip	:	98802-5348
Country	:	US
Telephone Number	:	909-260-0851
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/02/2020
Last Update Date	:	05/30/2023

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