Provider Demographics
NPI:1558038356
Name:LOVEJOY, JANIE (LMP)
Entity Type:Individual
Prefix:
First Name:JANIE
Middle Name:
Last Name:LOVEJOY
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 1:140 115TH ST E
Mailing Address - Street 2:
Mailing Address - City:PARKLAND
Mailing Address - State:WA
Mailing Address - Zip Code:98445-1714
Mailing Address - Country:US
Mailing Address - Phone:253-228-8493
Mailing Address - Fax:
Practice Address - Street 1:10828 GRAVELLY LAKE DR SW STE 108
Practice Address - Street 2:
Practice Address - City:LAKEWOOD
Practice Address - State:WA
Practice Address - Zip Code:98499-1300
Practice Address - Country:US
Practice Address - Phone:253-588-9731
Practice Address - Fax:253-588-9731
Is Sole Proprietor?:Yes
Enumeration Date:2021-08-27
Last Update Date:2021-08-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMA00016402225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist