Provider Demographics
NPI:1558415281
Name:POWNELL, JANET M (LMP)
Entity Type:Individual
Prefix:
First Name:JANET
Middle Name:M
Last Name:POWNELL
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 1:12905 E SPRAGUE AVE
Mailing Address - Street 2:
Mailing Address - City:SPOKANE VALLEY
Mailing Address - State:WA
Mailing Address - Zip Code:99216-0731
Mailing Address - Country:US
Mailing Address - Phone:509-922-0303
Mailing Address - Fax:509-922-0657
Practice Address - Street 1:12905 E SPRAGUE AVE
Practice Address - Street 2:
Practice Address - City:SPOKANE VALLEY
Practice Address - State:WA
Practice Address - Zip Code:99216-0731
Practice Address - Country:US
Practice Address - Phone:509-922-0303
Practice Address - Fax:509-922-0657
Is Sole Proprietor?:No
Enumeration Date:2007-01-22
Last Update Date:2007-11-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMA00019475225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA0200578OtherLABOR & INDUSTRIES
5036P0OtherASURIS PROVIDER ID
WA8942608OtherCRIME VICTIMS ID