Provider Demographics
NPI:1063814119
Name:READING, JESSIKA MAUREEN
Entity Type:Individual
Prefix:
First Name:JESSIKA
Middle Name:MAUREEN
Last Name:READING
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 1:108 S 4TH AVE
Mailing Address - Street 2:
Mailing Address - City:YAKIMA
Mailing Address - State:WA
Mailing Address - Zip Code:98902-3428
Mailing Address - Country:US
Mailing Address - Phone:509-654-2471
Mailing Address - Fax:509-225-7449
Practice Address - Street 1:108 S 4TH AVE
Practice Address - Street 2:
Practice Address - City:YAKIMA
Practice Address - State:WA
Practice Address - Zip Code:98902-3428
Practice Address - Country:US
Practice Address - Phone:509-654-2471
Practice Address - Fax:509-225-7449
Is Sole Proprietor?:Yes
Enumeration Date:2014-09-19
Last Update Date:2023-07-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMA 60485021225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist