Provider Demographics
NPI:1639202260
Name:RUMOHR, JASON R (LMP CHP)
Entity Type:Individual
Prefix:
First Name:JASON
Middle Name:R
Last Name:RUMOHR
Suffix:
Gender:M
Credentials:LMP CHP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1904 3RD AVE
Mailing Address - Street 2:SUITE 246
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98101-1126
Mailing Address - Country:US
Mailing Address - Phone:206-941-8811
Mailing Address - Fax:206-260-9074
Practice Address - Street 1:1904 3RD AVE
Practice Address - Street 2:SUITE 246
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98101-1126
Practice Address - Country:US
Practice Address - Phone:206-941-8811
Practice Address - Fax:206-260-9074
Is Sole Proprietor?:No
Enumeration Date:2007-03-13
Last Update Date:2008-06-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMA17981225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA171975OtherLABOR AND INDUSTRIES