Provider Demographics
NPI:1831656560
Name:SORIANO, JAYCEE CABIAO (LMT)
Entity Type:Individual
Prefix:
First Name:JAYCEE
Middle Name:CABIAO
Last Name:SORIANO
Suffix:
Gender:F
Credentials:LMT
Other - Prefix:
Other - First Name:JAYCEE
Other - Middle Name:SORIANO
Other - Last Name:BAGUYOS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:5539 ARCTIC BLVD APT 1
Mailing Address - Street 2:
Mailing Address - City:ANCHORAGE
Mailing Address - State:AK
Mailing Address - Zip Code:99518-1665
Mailing Address - Country:US
Mailing Address - Phone:907-230-8170
Mailing Address - Fax:
Practice Address - Street 1:5539 ARCTIC BLVD APT 1
Practice Address - Street 2:
Practice Address - City:ANCHORAGE
Practice Address - State:AK
Practice Address - Zip Code:99518-1665
Practice Address - Country:US
Practice Address - Phone:907-230-8170
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-02-28
Last Update Date:2019-02-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AK138916225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist