Doctor Name: | JORRELL-MARK TALADIAR ELBO |
NPI Number: | 1629391693 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | L.M.P. |
License Number: | MA60123564 |
Business Practice Address: | 24160 Ne State Route 3 1 & 2 Belfair, WA - 985289626 |
Business Phone Number: | 3602053085 |
Business Fax Number: | |
Mailing Address: | 24160 Ne State Roulte 3, Suite 1 & 2 BELFAIR |
State: | WA |
Postal Code: | 98528 |
Phone Number: | 3602053085 |
Fax Number: | |
NPI Enumeration Date: | 03/05/2010 |
NPI Last Update Date: | 03/05/2010 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 225700000X |
License Number: | MA60123564 |
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. |