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General NPI Number Information
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NPI Number | 1487788527
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Entity Type | Individual
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Provider Name | CARMI ROMONA JORGENSEN L.M.T. M.M.P.
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Gender | Female
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Dates
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Enumeration Date | 03/14/2007
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 5611 119TH AVE SE SUITE #4
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City | BELLEVUE
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State | WA
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Zip | 98006-3799
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Country | US
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Telephone | 425-644-6461
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Fax | 425-746-4965
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Provider Business Mailing Address
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Address Line | 4416 264TH AVE NE
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City | REDMOND
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State | WA
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Zip | 98053-8729
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Country | US
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Telephone | 425-644-6461
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Fax | 425-898-0289
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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 | MA00004373
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License Number State | WA
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