Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225700000X | Massage Therapist | MA00016055 | WA |
NPI | 1013199090 |
---|---|
Provider Name | Ms. Jesica R Ball |
First Address | Seattle, WA 98116-2008 |
Second Address | Seattle, WA 98101-3008 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 30/11/2007 |
Last Update Date | 17/03/2018 |