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NPI Code Detail

MEDICARE: MRS. PAMELA JEAN OWEN LMP

MEDICARE:  MRS. PAMELA JEAN OWEN  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
1225700000XMassage TherapistMA60037468WA

General Provider Information

NPI Number : 1891942124
Entity Type Code : Individual
Provider Name (Legal Business Name) : MRS. PAMELA JEAN OWEN LMP
Provider Business Mailing Address
First Line : 809 W MAIN ST
Second Line : STE C
City : MONROE
State : WA
Zip : 98272-2172
Country : US
Telephone Number : 425-870-3834
Fax Number : 360-794-4853
Provider Business Practice Location Address
First Line : 809 W MAIN ST
Second Line : SUITE C
City : MONROE
State : WA
Zip : 98272-2172
Country : US
Telephone Number : 425-870-3834
Fax Number : 360-794-4853
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/18/2008
Last Update Date : 04/21/2011

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Directions to “ MRS. PAMELA JEAN OWEN LMP” Practice Location

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