Provider Demographics
NPI:1245392935
Name:REED, JESSICA TREECE (LMP)
Entity Type:Individual
Prefix:MRS
First Name:JESSICA
Middle Name:TREECE
Last Name:REED
Suffix:
Gender:F
Credentials:LMP
Other - Prefix:MS
Other - First Name:JESSICA
Other - Middle Name:TREECE
Other - Last Name:LIPPERT
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LMP
Mailing Address - Street 1:1221 FULLER ST
Mailing Address - Street 2:
Mailing Address - City:WENATCHEE
Mailing Address - State:WA
Mailing Address - Zip Code:98801-3305
Mailing Address - Country:US
Mailing Address - Phone:509-664-1028
Mailing Address - Fax:509-664-3032
Practice Address - Street 1:1221 FULLER ST
Practice Address - Street 2:
Practice Address - City:WENATCHEE
Practice Address - State:WA
Practice Address - Zip Code:98801-3305
Practice Address - Country:US
Practice Address - Phone:509-664-1028
Practice Address - Fax:509-664-3032
Is Sole Proprietor?:No
Enumeration Date:2006-12-15
Last Update Date:2008-10-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMA12145225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist