Provider Demographics
NPI:1003958166
Name:HANDELMAN, JOAN MARIE (LMP)
Entity Type:Individual
Prefix:
First Name:JOAN
Middle Name:MARIE
Last Name:HANDELMAN
Suffix:
Gender:F
Credentials:LMP
Other - Prefix:
Other - First Name:JOAN
Other - Middle Name:MARIE
Other - Last Name:HANDELMAN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:6265 NE 159TH ST
Mailing Address - Street 2:
Mailing Address - City:KENMORE
Mailing Address - State:WA
Mailing Address - Zip Code:98028-4347
Mailing Address - Country:US
Mailing Address - Phone:206-920-1540
Mailing Address - Fax:
Practice Address - Street 1:13400 NE 20TH ST STE 3
Practice Address - Street 2:
Practice Address - City:BELLEVUE
Practice Address - State:WA
Practice Address - Zip Code:98005-2026
Practice Address - Country:US
Practice Address - Phone:425-401-8885
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-13
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMA00015306225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist