MEDICARE: JANELLE WASHINGTON CMT

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	65071	CO

General Provider Information

NPI Number	:	1538329958
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JANELLE WASHINGTON CMT

Provider Business Mailing Address
First Line	:	2774 S KNOX CT
Second Line	:
City	:	DENVER
State	:	CO
Zip	:	80236-2515
Country	:	US
Telephone Number	:	720-212-7999
Fax Number	:

Provider Business Practice Location Address
First Line	:	13801 E YALE AVE
Second Line	:	SUITE 116
City	:	AURORA
State	:	CO
Zip	:	80014-2337
Country	:	US
Telephone Number	:	720-212-7999
Fax Number	:	303-755-1109

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

Provider Enumeration Date	:	06/10/2008
Last Update Date	:	06/10/2008

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