Provider Demographics
NPI:1992378780
Name:APPLINGTON, JENNIFER ANN (MA00023483)
Entity Type:Individual
Prefix:
First Name:JENNIFER
Middle Name:ANN
Last Name:APPLINGTON
Suffix:
Gender:F
Credentials:MA00023483
Other - Prefix:
Other - First Name:JENNIFER
Other - Middle Name:ANN
Other - Last Name:DYVIG
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MA00023483
Mailing Address - Street 1:2518 E SUNSET DR
Mailing Address - Street 2:
Mailing Address - City:BELLINGHAM
Mailing Address - State:WA
Mailing Address - Zip Code:98226-5616
Mailing Address - Country:US
Mailing Address - Phone:360-644-7060
Mailing Address - Fax:
Practice Address - Street 1:2930 NEWMARKET ST STE 115
Practice Address - Street 2:
Practice Address - City:BELLINGHAM
Practice Address - State:WA
Practice Address - Zip Code:98226-3870
Practice Address - Country:US
Practice Address - Phone:360-656-5131
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-07-20
Last Update Date:2021-07-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMA00023483225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist