Provider Demographics
NPI:1518239011
Name:CAIN, JUSTINE L (LMP)
Entity Type:Individual
Prefix:MRS
First Name:JUSTINE
Middle Name:L
Last Name:CAIN
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 1:701 N 36TH ST STE 420
Mailing Address - Street 2:
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98103-8868
Mailing Address - Country:US
Mailing Address - Phone:206-547-5677
Mailing Address - Fax:206-547-5598
Practice Address - Street 1:701 N 36TH ST STE 420
Practice Address - Street 2:
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98103-8868
Practice Address - Country:US
Practice Address - Phone:206-547-5677
Practice Address - Fax:206-547-5598
Is Sole Proprietor?:No
Enumeration Date:2012-01-31
Last Update Date:2012-01-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMA60258024225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist