Healthcare Provider Details

I. General information

NPI: 1427359413
Provider Name (Legal Business Name): JENNIFER M FRANKLIN LMP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/08/2010
Last Update Date: 11/08/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1227 N GOERIG ST STE H
WOODLAND WA
98674-9741
US

IV. Provider business mailing address

280 INSEL RD
WOODLAND WA
98674-8298
US

V. Phone/Fax

Practice location:
  • Phone: 360-225-1200
  • Fax: 360-225-1266
Mailing address:
  • Phone: 360-852-3559
  • Fax: 360-225-1266

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225700000X
TaxonomyMassage Therapist
License NumberMA 60188583
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: