Healthcare Provider Details

I. General information

NPI: 1447577754
Provider Name (Legal Business Name): JAMES PEARREANT ESLINGER LMT
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/26/2010
Last Update Date: 04/26/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5512 NE 109TH CT SUITE A
VANCOUVER WA
98662-6175
US

IV. Provider business mailing address

5512 NE 109TH CT SUITE A
VANCOUVER WA
98662-6175
US

V. Phone/Fax

Practice location:
  • Phone: 360-885-4715
  • Fax: 360-859-3741
Mailing address:
  • Phone: 360-885-4715
  • Fax: 360-859-3741

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225700000X
TaxonomyMassage Therapist
License NumberMA60144664
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: