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General NPI Number Information
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NPI Number | 1962639468
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Entity Type | Individual
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Provider Name | KATHERINE JAKIELSKI LMP
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Gender | Female
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Dates
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Enumeration Date | 06/11/2009
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Last Update Date | 08/20/2009
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Provider Practice Location Address
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Address Line | 320 MELROSE AVE E APT 701
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City | SEATTLE
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State | WA
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Zip | 98102-6600
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Country | US
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Telephone | 206-399-8820
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Fax |
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Provider Business Mailing Address
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Address Line | 320 MELROSE AVE E. #701
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City | SEATTLE
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State | WA
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Zip | 98102
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Country | US
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Telephone | 206-399-8820
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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 | MA60018838
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License Number State | WA
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