Healthcare Provider Details

I. General information

NPI: 1548647316
Provider Name (Legal Business Name): JULIE JENKINS, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/30/2015
Last Update Date: 09/24/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9500 ROOSEVELT WAY NE STE 200A
SEATTLE WA
98115-2253
US

IV. Provider business mailing address

19527 14TH AVE NE UNIT A
SHORELINE WA
98155-1111
US

V. Phone/Fax

Practice location:
  • Phone: 206-661-6195
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code171100000X
TaxonomyAcupuncturist
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code225700000X
TaxonomyMassage Therapist
License Number
License Number State

VIII. Authorized Official

Name: JULIE JENKINS
Title or Position: OWNER
Credential:
Phone: 206-661-6195