Provider Demographics
NPI:1255604880
Name:ZIPFEL, JAMAICA SHANELL-MARIE (LMP)
Entity type:Individual
Prefix:
First Name:JAMAICA
Middle Name:SHANELL-MARIE
Last Name:ZIPFEL
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 1:3820 S 320TH ST
Mailing Address - Street 2:
Mailing Address - City:AUBURN
Mailing Address - State:WA
Mailing Address - Zip Code:98001-3115
Mailing Address - Country:US
Mailing Address - Phone:253-839-2650
Mailing Address - Fax:253-839-4528
Practice Address - Street 1:3820 S 320TH ST
Practice Address - Street 2:
Practice Address - City:AUBURN
Practice Address - State:WA
Practice Address - Zip Code:98001-3115
Practice Address - Country:US
Practice Address - Phone:253-839-2650
Practice Address - Fax:253-839-4528
Is Sole Proprietor?:No
Enumeration Date:2012-02-13
Last Update Date:2012-02-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMA60221605225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist