Healthcare Provider Details

I. General information

NPI: 1396522983
Provider Name (Legal Business Name): JENNIFER ZOOK LMT
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/08/2023
Last Update Date: 09/08/2023
Certification Date: 09/08/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3727 CALIFORNIA AVE SW STE 2A
SEATTLE WA
98116-4303
US

IV. Provider business mailing address

3204 47TH AVE SW
SEATTLE WA
98116-3317
US

V. Phone/Fax

Practice location:
  • Phone: 206-745-0177
  • Fax:
Mailing address:
  • Phone: 206-595-2794
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225700000X
TaxonomyMassage Therapist
License NumberMA00012451
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: