Provider Demographics
NPI:1467539627
Name:PARKHURST, JOSIE VANESSA (LMT)
Entity Type:Individual
Prefix:
First Name:JOSIE
Middle Name:VANESSA
Last Name:PARKHURST
Suffix:
Gender:F
Credentials:LMT
Other - Prefix:
Other - First Name:JOSIE
Other - Middle Name:VANESSA
Other - Last Name:IVES
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:8401 5TH AVE NE
Mailing Address - Street 2:SUITE 102
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98105
Mailing Address - Country:US
Mailing Address - Phone:206-349-5651
Mailing Address - Fax:888-502-7127
Practice Address - Street 1:8401 5TH AVE NE
Practice Address - Street 2:SUITE 102
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98105
Practice Address - Country:US
Practice Address - Phone:206-349-5651
Practice Address - Fax:888-502-7127
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-01
Last Update Date:2016-11-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMA00019544225700000X
225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist