Provider Demographics
NPI:1033466636
Name:JAWASKI, AMBER
Entity Type:Individual
Prefix:
First Name:AMBER
Middle Name:
Last Name:JAWASKI
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2937 LYNDALE AVE S
Mailing Address - Street 2:SUITE 201
Mailing Address - City:MINNEAPOLIS
Mailing Address - State:MN
Mailing Address - Zip Code:55408-2177
Mailing Address - Country:US
Mailing Address - Phone:612-879-8000
Mailing Address - Fax:612-879-8778
Practice Address - Street 1:2937 LYNDALE AVE S
Practice Address - Street 2:SUITE 201
Practice Address - City:MINNEAPOLIS
Practice Address - State:MN
Practice Address - Zip Code:55408-2177
Practice Address - Country:US
Practice Address - Phone:612-879-8000
Practice Address - Fax:612-879-8778
Is Sole Proprietor?:Yes
Enumeration Date:2012-08-14
Last Update Date:2012-08-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist