Provider Demographics
NPI:1043843311
Name:JEROMA, SOPHIE (MT-BC)
Entity Type:Individual
Prefix:
First Name:SOPHIE
Middle Name:
Last Name:JEROMA
Suffix:
Gender:F
Credentials:MT-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8401 5TH AVE NE STE 101
Mailing Address - Street 2:
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98115-4186
Mailing Address - Country:US
Mailing Address - Phone:206-880-0593
Mailing Address - Fax:
Practice Address - Street 1:8401 5TH AVE NE STE 101
Practice Address - Street 2:
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98115-4186
Practice Address - Country:US
Practice Address - Phone:206-880-0593
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-02-14
Last Update Date:2024-04-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225A00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMusic Therapist