Doctor Name: | JESSIKA GLEASON |
NPI Number: | 1063814119 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | |
License Number: | MA 60485021 |
Business Practice Address: | 305 S 11th Ave Ste 2 Yakima, WA - 989023200 |
Business Phone Number: | 5092257450 |
Business Fax Number: | 5092257449 |
Mailing Address: | 305 S 11th Ave Ste 2, YAKIMA |
State: | WA |
Postal Code: | 989023200 |
Phone Number: | 5092257450 |
Fax Number: | 5092257449 |
NPI Enumeration Date: | 09/19/2014 |
NPI Last Update Date: | 09/19/2014 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 225700000X |
License Number: | MA 60485021 |
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. |