MEDICARE: ADRIEL JEANNE STEWART 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	MA60247103	WA

General Provider Information

NPI Number	:	1578843082
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ADRIEL JEANNE STEWART LMP

Provider Business Mailing Address
First Line	:	1227 S 136TH ST
Second Line	:
City	:	BURIEN
State	:	WA
Zip	:	98168-2861
Country	:	US
Telephone Number	:	253-709-5701
Fax Number	:

Provider Business Practice Location Address
First Line	:	9455 35TH AVE SW STE E
Second Line	:
City	:	SEATTLE
State	:	WA
Zip	:	98126-3898
Country	:	US
Telephone Number	:	206-932-8320
Fax Number	:

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

Provider Enumeration Date	:	08/29/2011
Last Update Date	:	08/29/2011

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Directions to “ ADRIEL JEANNE STEWART LMP” Practice Location

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