Provider Demographics
NPI:1164751277
Name:ROMMEREIM, JENNIFER ALINE (LMP)
Entity Type:Individual
Prefix:MISS
First Name:JENNIFER
Middle Name:ALINE
Last Name:ROMMEREIM
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 1:3611 I ST NE UNIT 27
Mailing Address - Street 2:
Mailing Address - City:AUBURN
Mailing Address - State:WA
Mailing Address - Zip Code:98002-1816
Mailing Address - Country:US
Mailing Address - Phone:206-419-7350
Mailing Address - Fax:
Practice Address - Street 1:3611 I ST NE UNIT 27
Practice Address - Street 2:
Practice Address - City:AUBURN
Practice Address - State:WA
Practice Address - Zip Code:98002-1816
Practice Address - Country:US
Practice Address - Phone:206-419-7350
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-12-18
Last Update Date:2009-12-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMA60125403225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist