Doctor Name: | JESSICA LEIGH WATKINS |
NPI Number: | 1053720813 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | LMP |
License Number: | MA00021620 |
Business Practice Address: | 3401 Se 192nd Ave Vancouver, WA - 98683 |
Business Phone Number: | 3608827733 |
Business Fax Number: | |
Mailing Address: | 1620 Ne 144th Ave, PORTLAND |
State: | OR |
Postal Code: | 972304117 |
Phone Number: | 9712756761 |
Fax Number: | |
NPI Enumeration Date: | 08/06/2014 |
NPI Last Update Date: | 08/06/2014 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 225700000X |
License Number: | MA00021620 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | WA |
Taxonomy Type: | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
Taxonomy Classification: | Massage Therapist |
Taxonomy Specialization: | |
Taxonomy Definition: | An individual trained in the manipulation of tissues (as by rubbing, stroking, kneading, or tapping) with the hand or an instrument for remedial or hygienic purposes. |