MEDICARE: JASON R RUMOHR L.M.P. C.H.P.

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	MA17981	WA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	171975	OTHER	WA	LABOR AND INDUSTRIES

General Provider Information

NPI Number	:	1639202260
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JASON R RUMOHR L.M.P. C.H.P.

Provider Business Mailing Address
First Line	:	1904 3RD AVE
Second Line	:	SUITE 246
City	:	SEATTLE
State	:	WA
Zip	:	98101-1126
Country	:	US
Telephone Number	:	206-941-8811
Fax Number	:	206-260-9074

Provider Business Practice Location Address
First Line	:	1904 3RD AVE
Second Line	:	SUITE 246
City	:	SEATTLE
State	:	WA
Zip	:	98101-1126
Country	:	US
Telephone Number	:	206-941-8811
Fax Number	:	206-260-9074

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

Provider Enumeration Date	:	03/13/2007
Last Update Date	:	06/19/2008

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