Healthcare Provider Details

I. General information

NPI: 1881807287
Provider Name (Legal Business Name): JASMINE LORI HUTCHINSON LMP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/08/2007
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

11671 SE 1ST ST SUITE 302
BELLEVUE WA
98005-3759
US

IV. Provider business mailing address

16677 167TH ST SE
MONROE WA
98272-2905
US

V. Phone/Fax

Practice location:
  • Phone: 425-301-6842
  • Fax:
Mailing address:
  • Phone: 206-919-1972
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225700000X
TaxonomyMassage Therapist
License NumberMA00021680
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: