Mrs. Jessica Anne Mccullough
Massage Therapist
2550 Ne 2nd Pl
Renton
, Washington 98056-5812
Mrs. Jessica Anne Mccullough
Massage Therapist
2550 Ne 2nd Pl
Renton
, Washington 98056-5812
(425) 922-4841
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About
Features
Specialties
- Massage Therapist
Languages spoken
- English
Location
First Address
- Mrs. Jessica Anne Mccullough
- 2550 Ne 2nd Pl
- Renton, WA
- Zip : 98056-5812
- Phone : (425) 922-4841
Second Address
- Mrs. Jessica Anne Mccullough
- 2550 Ne 2nd Pl
- Renton, WA
- Zip : 98056-5812
- Phone : (425) 922-4841
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Is Mrs. Jessica Anne Mccullough a sole practitioner?
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Scope of Practice
| Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
|---|---|---|---|---|
| Y | 225700000X | Massage Therapist | MA60049026 | WA |
National Provider Identifier
| NPI | 1013162866 |
|---|---|
| Provider Name | Mrs. Jessica Anne Mccullough |
| First Address | Renton, WA 98056-5812 |
| Second Address | Renton, WA 98056-5812 |
| Gender | F |
| NPI Entity type | Individual |
| Is Sole Proprietor | Yes |
| Is Organization Subpart | N/A |
| Enumeration Date | 20/11/2008 |
| Last Update Date | 20/11/2008 |
NPI Footnotes
What is the National Provider Identifier (NPI)
Provider Location Address
Provider Mailing Address
Entity Type Code
1= Person: individual human being who furnishes health care;
2= Non-person: entity other than an individual human being that furnishes health care (Examples: hospital, SNF, hospital subunit, pharmacy, or HMO)
What is a Subpart?
Provider Other Organization Name
1 = former name;
2 = professional name;
3 = doinq business as (d/b/ a) name;
4 = former legal business name;
5 = other.