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General NPI Number Information
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NPI Number | 1649664145
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Entity Type | Organization
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Legal Business Name | JILL BRANDON MASSAGE THERAPY
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Dates
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Enumeration Date | 03/23/2015
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Last Update Date | 03/23/2015
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Provider Practice Location Address
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Address Line | 2310 N CHERRY ST # 110
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City | SPOKANE VALLEY
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State | WA
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Zip | 99216-1152
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Country | US
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Telephone | 509-991-8520
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Fax |
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Provider Business Mailing Address
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Address Line | 13316 E 25TH AVE
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City | SPOKANE VALLEY
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State | WA
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Zip | 99216-2812
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Country | US
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Telephone | 509-991-8520
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Fax |
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Authorized Official
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Title or Position | LICENSED MASSAGE THERAPIST
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Name | JILL BRANDON
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Credential | LMP
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Telephone | 509-991-8520
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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 |
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License Number State | WA
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