Provider Demographics
NPI:1437470911
Name:BARRETT, JILLIAN NOEL (LMP)
Entity Type:Individual
Prefix:MISS
First Name:JILLIAN
Middle Name:NOEL
Last Name:BARRETT
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 1:227 SYMONS ST
Mailing Address - Street 2:A&B
Mailing Address - City:RICHLAND
Mailing Address - State:WA
Mailing Address - Zip Code:99354-3423
Mailing Address - Country:US
Mailing Address - Phone:509-946-9658
Mailing Address - Fax:
Practice Address - Street 1:227 SYMONS ST
Practice Address - Street 2:A&B
Practice Address - City:RICHLAND
Practice Address - State:WA
Practice Address - Zip Code:99354-3423
Practice Address - Country:US
Practice Address - Phone:509-946-9658
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-06-18
Last Update Date:2010-06-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMA 60097269225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist