Provider Demographics
NPI:1114353166
Name:LANGLOIS, JANELL ROSE (LMP)
Entity Type:Individual
Prefix:MS
First Name:JANELL
Middle Name:ROSE
Last Name:LANGLOIS
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 1:11430 51ST AVE NW
Mailing Address - Street 2:SUITE 101A
Mailing Address - City:GIG HARBOR
Mailing Address - State:WA
Mailing Address - Zip Code:98332-7897
Mailing Address - Country:US
Mailing Address - Phone:253-857-6500
Mailing Address - Fax:253-857-2225
Practice Address - Street 1:11430 51ST AVE NW
Practice Address - Street 2:SUITE 101A
Practice Address - City:GIG HARBOR
Practice Address - State:WA
Practice Address - Zip Code:98332-7897
Practice Address - Country:US
Practice Address - Phone:253-857-6500
Practice Address - Fax:253-857-2225
Is Sole Proprietor?:Yes
Enumeration Date:2013-09-23
Last Update Date:2013-09-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMA00022690174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist