Provider Demographics
NPI:1477113587
Name:JESSICA JARAMILLO, LLC
Entity Type:Organization
Organization Name:JESSICA JARAMILLO, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEDICAL MASSAGE THERAPIST
Authorized Official - Prefix:
Authorized Official - First Name:JESSICA
Authorized Official - Middle Name:J
Authorized Official - Last Name:LINDBO
Authorized Official - Suffix:
Authorized Official - Credentials:LMT, FMT
Authorized Official - Phone:253-209-8535
Mailing Address - Street 1:23817 109TH STREET CT E
Mailing Address - Street 2:
Mailing Address - City:BUCKLEY
Mailing Address - State:WA
Mailing Address - Zip Code:98321-8701
Mailing Address - Country:US
Mailing Address - Phone:253-209-8535
Mailing Address - Fax:253-845-5811
Practice Address - Street 1:16515 MERIDIAN E STE 103B
Practice Address - Street 2:
Practice Address - City:PUYALLUP
Practice Address - State:WA
Practice Address - Zip Code:98375-6252
Practice Address - Country:US
Practice Address - Phone:
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-06-20
Last Update Date:2019-06-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage TherapistGroup - Single Specialty