Provider Demographics
NPI:1497148761
Name:MUHLHAUSER, JAYLA ANN (LMP)
Entity Type:Individual
Prefix:
First Name:JAYLA
Middle Name:ANN
Last Name:MUHLHAUSER
Suffix:
Gender:F
Credentials:LMP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:428 E ELMA AVE
Mailing Address - Street 2:
Mailing Address - City:MONTESANO
Mailing Address - State:WA
Mailing Address - Zip Code:98563-3826
Mailing Address - Country:US
Mailing Address - Phone:360-300-7184
Mailing Address - Fax:360-861-8095
Practice Address - Street 1:302 SOUTH FOURTH STREET
Practice Address - Street 2:
Practice Address - City:SATSOP
Practice Address - State:WA
Practice Address - Zip Code:98583-9900
Practice Address - Country:US
Practice Address - Phone:360-300-7184
Practice Address - Fax:360-861-8095
Is Sole Proprietor?:Yes
Enumeration Date:2015-03-11
Last Update Date:2024-04-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMA60543393225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA1497148761OtherNPI