MEDICARE: JENNIFER ALLISON ROWE LMP

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	225700000X	Massage Therapist	MA 00014724	WA

General Provider Information

NPI Number	:	1205190378
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JENNIFER ALLISON ROWE LMP

Provider Business Mailing Address
First Line	:	221 KENYON ST NW
Second Line	:
City	:	OLYMPIA
State	:	WA
Zip	:	98502-4581
Country	:	US
Telephone Number	:	360-705-1133
Fax Number	:	360-352-5855

Provider Business Practice Location Address
First Line	:	221 KENYON ST NW
Second Line	:
City	:	OLYMPIA
State	:	WA
Zip	:	98502-4581
Country	:	US
Telephone Number	:	360-705-1133
Fax Number	:	360-352-5855

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/03/2012
Last Update Date	:	06/10/2024

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