Provider Demographics
NPI:1497176259
Name:JURCA, LINDA (LMP, RYT)
Entity Type:Individual
Prefix:PROF
First Name:LINDA
Middle Name:
Last Name:JURCA
Suffix:
Gender:F
Credentials:LMP, RYT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:31637 1ST PL S
Mailing Address - Street 2:
Mailing Address - City:FEDERAL WAY
Mailing Address - State:WA
Mailing Address - Zip Code:98003-5224
Mailing Address - Country:US
Mailing Address - Phone:206-669-1284
Mailing Address - Fax:
Practice Address - Street 1:31637 1ST PL S
Practice Address - Street 2:
Practice Address - City:FEDERAL WAY
Practice Address - State:WA
Practice Address - Zip Code:98003-5224
Practice Address - Country:US
Practice Address - Phone:206-669-1284
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-12-21
Last Update Date:2013-12-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMA 60284682172V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes172V00000XOther Service ProvidersCommunity Health Worker