Provider Demographics
NPI:1407091598
Name:HENDRIX, JAMAICA ANNE (LMP)
Entity Type:Individual
Prefix:
First Name:JAMAICA
Middle Name:ANNE
Last Name:HENDRIX
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 1:18021 WAVERLY DR
Mailing Address - Street 2:
Mailing Address - City:SNOHOMISH
Mailing Address - State:WA
Mailing Address - Zip Code:98296-8016
Mailing Address - Country:US
Mailing Address - Phone:206-914-0016
Mailing Address - Fax:
Practice Address - Street 1:18021 WAVERLY DR
Practice Address - Street 2:
Practice Address - City:SNOHOMISH
Practice Address - State:WA
Practice Address - Zip Code:98296-8016
Practice Address - Country:US
Practice Address - Phone:206-914-0016
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-12-03
Last Update Date:2008-12-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMA60043237225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist