Provider Demographics
NPI:1902037435
Name:WOLFE, JANETMARIE (LMP)
Entity Type:Individual
Prefix:
First Name:JANETMARIE
Middle Name:
Last Name:WOLFE
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 1:718 STATE ST S
Mailing Address - Street 2:
Mailing Address - City:KIRKLAND
Mailing Address - State:WA
Mailing Address - Zip Code:98033-6623
Mailing Address - Country:US
Mailing Address - Phone:425-417-7546
Mailing Address - Fax:
Practice Address - Street 1:718 STATE ST S
Practice Address - Street 2:
Practice Address - City:KIRKLAND
Practice Address - State:WA
Practice Address - Zip Code:98033-6623
Practice Address - Country:US
Practice Address - Phone:425-417-7546
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-07-31
Last Update Date:2012-02-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMA00016753225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist