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NPI Code Detail

MEDICARE: MS. JESSICA STEVENS L.M.P.

MEDICARE: MS. JESSICA STEVENS L.M.P.
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 TherapistMA 60392624WA

General Provider Information

NPI Number : 1679906788
Entity Type Code : Individual
Provider Name (Legal Business Name) : MS. JESSICA STEVENS L.M.P.
Provider Business Mailing Address
First Line : 10209 E MISSION AVE
Second Line :
City : SPOKANE VALLEY
State : WA
Zip : 99206-3943
Country : US
Telephone Number : 509-655-4135
Fax Number :
Provider Business Practice Location Address
First Line : 2207 N MOLTER RD STE 250
Second Line :
City : LIBERTY LAKE
State : WA
Zip : 99019-7582
Country : US
Telephone Number : 509-893-9939
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/12/2013
Last Update Date : 01/12/2016

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