Healthcare Provider Details
I. General information
NPI: 1700584919
Provider Name (Legal Business Name): JAMIE ESPELAND
Entity Type: Individual
Gender: Female
Sole Proprietor: Y
II. Dates (important events)
Enumeration Date: 02/16/2023
Last Update Date: 02/16/2023
Certification Date: 02/16/2023
Deactivation Date:
Reactivation Date:
III. Provider practice location address
18205 ALDERWOOD MALL PKWY STE A SUITE 404
LYNNWOOD WA
98037
US
IV. Provider business mailing address
3504 FENDER DR
LYNNWOOD WA
98087-5223
US
V. Phone/Fax
- Phone: 425-231-5780
- Fax:
- Phone: 425-231-5780
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 225700000X |
| Taxonomy | Massage Therapist |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: