MEDICARE: JULIE JENKINS, LLC

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
2	171100000X	Acupuncturist

General Provider Information

NPI Number	:	1548647316
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	JULIE JENKINS, LLC

Provider Business Mailing Address
First Line	:	19527 14TH AVE NE UNIT A
Second Line	:
City	:	SHORELINE
State	:	WA
Zip	:	98155-1111
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	9500 ROOSEVELT WAY NE STE 200A
Second Line	:
City	:	SEATTLE
State	:	WA
Zip	:	98115-2253
Country	:	US
Telephone Number	:	206-661-6195
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	JULIE JENKINS
Credential	:
Telephone Number	:	206-661-6195

Provider Enumeration Date	:	04/30/2015
Last Update Date	:	09/24/2015

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