Provider Demographics
NPI:1073739868
Name:ARNDT, JENNIFER LUCILLE (LMP)
Entity Type:Individual
Prefix:
First Name:JENNIFER
Middle Name:LUCILLE
Last Name:ARNDT
Suffix:
Gender:F
Credentials:LMP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12704 MUKILTEO SPEEDWAY
Mailing Address - Street 2:STE C
Mailing Address - City:MUKILTEO
Mailing Address - State:WA
Mailing Address - Zip Code:98275-5720
Mailing Address - Country:US
Mailing Address - Phone:425-290-1919
Mailing Address - Fax:
Practice Address - Street 1:12704 MUKILTEO SPEEDWAY
Practice Address - Street 2:STE C
Practice Address - City:MUKILTEO
Practice Address - State:WA
Practice Address - Zip Code:98275-5720
Practice Address - Country:US
Practice Address - Phone:425-290-1919
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-04-18
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMA00023504225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist