Healthcare Provider Details

I. General information

NPI: 1699131102
Provider Name (Legal Business Name): JULIANA RADLOFF LMP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/13/2016
Last Update Date: 01/13/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10021 HOLMAN RD NW
SEATTLE WA
98177-4920
US

IV. Provider business mailing address

8516 DIBBLE AVE NW
SEATTLE WA
98117-3247
US

V. Phone/Fax

Practice location:
  • Phone: 206-632-8300
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225700000X
TaxonomyMassage Therapist
License NumberMA60486683
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: