Healthcare Provider Details

I. General information

NPI: 1194635912
Provider Name (Legal Business Name): AMY JUNTUNEN LMT
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/11/2026
Last Update Date: 09/11/2026
Certification Date: 09/11/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

748 W LUANA LN
BLUFFDALE UT
84065-1607
US

IV. Provider business mailing address

748 W LUANA LN
BLUFFDALE UT
84065-1607
US

V. Phone/Fax

Practice location:
  • Phone: 425-409-4483
  • Fax:
Mailing address:
  • Phone: 425-409-4483
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225700000X
TaxonomyMassage Therapist
License Number14299663-4701
License Number StateUT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: