Provider Demographics
NPI:1346756640
Name:MENTER, JANEL COLEEN (LMT)
Entity Type:Individual
Prefix:
First Name:JANEL
Middle Name:COLEEN
Last Name:MENTER
Suffix:
Gender:F
Credentials:LMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:213805 E GAME FARM RD
Mailing Address - Street 2:
Mailing Address - City:KENNEWICK
Mailing Address - State:WA
Mailing Address - Zip Code:99337-9155
Mailing Address - Country:US
Mailing Address - Phone:860-459-9380
Mailing Address - Fax:
Practice Address - Street 1:134 KEENE RD
Practice Address - Street 2:
Practice Address - City:RICHLAND
Practice Address - State:WA
Practice Address - Zip Code:99352-8683
Practice Address - Country:US
Practice Address - Phone:509-628-9966
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-12-21
Last Update Date:2017-12-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA60800954225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist