Provider Demographics
NPI:1457569956
Name:BARTHOLOMEW, MARY JO DIGESU (LICENSED MASSAGE THE)
Entity Type:Individual
Prefix:MRS
First Name:MARY JO
Middle Name:DIGESU
Last Name:BARTHOLOMEW
Suffix:
Gender:F
Credentials:LICENSED MASSAGE THE
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9349 E LEAVENWORTH RD
Mailing Address - Street 2:
Mailing Address - City:LEAVENWORTH
Mailing Address - State:WA
Mailing Address - Zip Code:98826
Mailing Address - Country:US
Mailing Address - Phone:509-548-1473
Mailing Address - Fax:
Practice Address - Street 1:9349 E LEAVENWORTH RD
Practice Address - Street 2:
Practice Address - City:LEAVENWORTH
Practice Address - State:WA
Practice Address - Zip Code:98826
Practice Address - Country:US
Practice Address - Phone:509-782-1251
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-05-18
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMA00012209225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist