Provider Demographics
NPI:1932318094
Name:JARAMILLO, LETICIA MARIA (LAC DIPLOM)
Entity Type:Individual
Prefix:MS
First Name:LETICIA
Middle Name:MARIA
Last Name:JARAMILLO
Suffix:
Gender:F
Credentials:LAC DIPLOM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2507 E JOHN ST
Mailing Address - Street 2:
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98112-5494
Mailing Address - Country:US
Mailing Address - Phone:206-324-3505
Mailing Address - Fax:206-324-3505
Practice Address - Street 1:2507 E JOHN ST
Practice Address - Street 2:
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98112-5494
Practice Address - Country:US
Practice Address - Phone:206-683-9756
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-05-22
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAAC00002800171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist