Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225700000X | Massage Therapist | MA 60183767 | WA |
NPI | 1003117326 |
---|---|
Provider Name | Jennifer Lynn Trunkey |
First Address | Spokane Valley, WA 99206-5290 |
Second Address | Spokane Valley, WA 99206-5290 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 03/11/2010 |
Last Update Date | 28/05/2014 |