Provider Demographics
NPI:1326329335
Name:JOBB, CHRISTA (LMP)
Entity Type:Individual
Prefix:
First Name:CHRISTA
Middle Name:
Last Name:JOBB
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 1:4519 JOHNSON POINT RD NE
Mailing Address - Street 2:
Mailing Address - City:OLYMPIA
Mailing Address - State:WA
Mailing Address - Zip Code:98516-9123
Mailing Address - Country:US
Mailing Address - Phone:360-259-9788
Mailing Address - Fax:
Practice Address - Street 1:8286 28TH CT NE STE 103
Practice Address - Street 2:
Practice Address - City:LACEY
Practice Address - State:WA
Practice Address - Zip Code:98516-7139
Practice Address - Country:US
Practice Address - Phone:360-250-3076
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-09-02
Last Update Date:2012-10-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMA60241086225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist