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General NPI Number Information
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NPI Number | 1134806599
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Entity Type | Individual
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Provider Name | JARED J SHINKARUK MA61459672
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Gender | Male
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Dates
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Enumeration Date | 06/28/2023
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Last Update Date | 06/28/2023
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Provider Practice Location Address
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Address Line | 1487 NE DAWN RD
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City | BREMERTON
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State | WA
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Zip | 98311-3122
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Country | US
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Telephone | 360-373-8899
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Fax |
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Provider Business Mailing Address
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Address Line | 6137 SNOWBERRY LN NE
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City | BREMERTON
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State | WA
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Zip | 98311-3177
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Country | US
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Telephone | 360-434-0333
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 225700000X
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Taxonomy Name | Massage Therapist
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License Number | MA61459672
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License Number State | WA
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