MEDICARE: JESSICA CABATIT 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	MA00018178	WA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	0190470	OTHER	WA	DEPT OF LABOR & INDUSTRIE

General Provider Information

NPI Number	:	1356477988
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JESSICA CABATIT LMP

Provider Business Mailing Address
First Line	:	22019 39TH PL S
Second Line	:
City	:	KENT
State	:	WA
Zip	:	98032-8429
Country	:	US
Telephone Number	:	425-269-5377
Fax Number	:

Provider Business Practice Location Address
First Line	:	1100 19TH AVE E
Second Line	:
City	:	SEATTLE
State	:	WA
Zip	:	98112-3505
Country	:	US
Telephone Number	:	206-324-0664
Fax Number	:	206-324-1969

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

Provider Enumeration Date	:	02/26/2007
Last Update Date	:	07/08/2007

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