Provider Demographics
NPI:1033503636
Name:HNAT, JACQUELINE FAITH (MA60493861)
Entity Type:Individual
Prefix:MS
First Name:JACQUELINE
Middle Name:FAITH
Last Name:HNAT
Suffix:
Gender:F
Credentials:MA60493861
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1310 MINOR AVE APT 408
Mailing Address - Street 2:
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98101-2879
Mailing Address - Country:US
Mailing Address - Phone:443-699-8055
Mailing Address - Fax:
Practice Address - Street 1:1524 4TH AVE
Practice Address - Street 2:
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98101-1602
Practice Address - Country:US
Practice Address - Phone:206-624-1370
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-03-23
Last Update Date:2015-03-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMA60493861225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist