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General NPI Number Information
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NPI Number | 1184885089
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Entity Type | Individual
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Provider Name | JUSTINE LORRAINE ALLEN LMP
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Gender | Female
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Dates
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Enumeration Date | 06/23/2008
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Last Update Date | 03/24/2011
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Provider Practice Location Address
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Address Line | 5106 PARKER RD E #C
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City | SUMNER
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State | WA
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Zip | 98390-2852
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Country | US
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Telephone | 253-221-3588
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Fax |
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Provider Business Mailing Address
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Address Line | 5106 PARKER RD E #C
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City | SUMNER
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State | WA
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Zip | 98390-2852
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Country | US
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Telephone | 253-221-3588
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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 | MA00013688
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License Number State | WA
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