Healthcare Provider Details

I. General information

NPI: 1033556865
Provider Name (Legal Business Name): JILL M MORRIS LMP
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/03/2013
Last Update Date: 09/02/2021
Certification Date: 09/02/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2255 HARBOR AVE SW #205
SEATTLE WA
98126-2086
US

IV. Provider business mailing address

2255 HARBOR AVE SW #205
SEATTLE WA
98126-2086
US

V. Phone/Fax

Practice location:
  • Phone: 206-851-5607
  • Fax:
Mailing address:
  • Phone: 206-851-5607
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code164W00000X
TaxonomyLicensed Practical Nurse
License NumberLP00051449
License Number StateWA
# 2
Primary TaxonomyN
Taxonomy Code225700000X
TaxonomyMassage Therapist
License NumberMA60342761
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: