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NPI Code Detail

MEDICARE: JILL BRANDON MASSAGE THERAPY

MEDICARE: JILL BRANDON MASSAGE THERAPY
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
1225700000XMassage TherapistWA

General Provider Information

NPI Number : 1649664145
Entity Type Code : Organization
Provider Name (Legal Business Name) : JILL BRANDON MASSAGE THERAPY
Provider Business Mailing Address
First Line : 13316 E 25TH AVE
Second Line :
City : SPOKANE VALLEY
State : WA
Zip : 99216-2812
Country : US
Telephone Number : 509-991-8520
Fax Number :
Provider Business Practice Location Address
First Line : 2310 N CHERRY ST # 110
Second Line :
City : SPOKANE VALLEY
State : WA
Zip : 99216-1152
Country : US
Telephone Number : 509-991-8520
Fax Number :
Authorized Official
Title or Position : LICENSED MASSAGE THERAPIST
Name : JILL BRANDON
Credential : LMP
Telephone Number : 509-991-8520
Provider Enumeration Date : 03/23/2015
Last Update Date : 03/23/2015

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Directions to “JILL BRANDON MASSAGE THERAPY ” Practice Location

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