Healthcare Provider Details

I. General information

NPI: 1013440007
Provider Name (Legal Business Name): JMSM SERVICES INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/06/2017
Last Update Date: 04/06/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5920 100TH ST SW STE 22
LAKEWOOD WA
98499-2751
US

IV. Provider business mailing address

5920 100TH ST SW STE 22
LAKEWOOD WA
98499-2751
US

V. Phone/Fax

Practice location:
  • Phone: 253-370-6868
  • Fax: 253-449-0564
Mailing address:
  • Phone: 253-370-6868
  • Fax: 253-449-0564

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225700000X
TaxonomyMassage Therapist
License NumberMA00019236
License Number StateWA

VIII. Authorized Official

Name: JENNIFER MOORHEAD
Title or Position: OWNER
Credential: LMT
Phone: 253-370-6868