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General NPI Number Information
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NPI Number | 1881929479
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Entity Type | Individual
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Provider Name | JESSICA ANN DELAROSA
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Gender | Female
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Dates
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Enumeration Date | 10/15/2009
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Last Update Date | 10/15/2009
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Provider Practice Location Address
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Address Line | 3180 W CLEARWATER AVE STE. F.
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City | KENNEWICK
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State | WA
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Zip | 99336-2767
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Country | US
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Telephone | 509-969-3792
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Fax | 509-783-6675
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Provider Business Mailing Address
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Address Line | 2341 SUNSET WAY
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City | COWICHE
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State | WA
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Zip | 98923-9718
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Country | US
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Telephone | 509-969-3792
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Fax | 509-783-6675
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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 | MA 60111627
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License Number State | WA
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