Provider Demographics
NPI:1184911224
Name:PEREZ, JAMES A
Entity type:Individual
Prefix:MR
First Name:JAMES
Middle Name:A
Last Name:PEREZ
Suffix:
Gender:M
Credentials:
Other - Prefix:MR
Other - First Name:JAMES
Other - Middle Name:A
Other - Last Name:PEREZ
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:LMP
Mailing Address - Street 1:511 E MAGNOLIA ST
Mailing Address - Street 2:
Mailing Address - City:BELLINGHAM
Mailing Address - State:WA
Mailing Address - Zip Code:98225-4559
Mailing Address - Country:US
Mailing Address - Phone:360-647-1970
Mailing Address - Fax:
Practice Address - Street 1:511 E MAGNOLIA ST
Practice Address - Street 2:
Practice Address - City:BELLINGHAM
Practice Address - State:WA
Practice Address - Zip Code:98225-4559
Practice Address - Country:US
Practice Address - Phone:360-647-1970
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-07-08
Last Update Date:2011-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMA00010995225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist