Provider Demographics
NPI:1497196679
Name:DELANCY, JENNY LIND (LMP)
Entity type:Individual
Prefix:MS
First Name:JENNY
Middle Name:LIND
Last Name:DELANCY
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 1:5525 AIRPORT RD
Mailing Address - Street 2:
Mailing Address - City:CASHMERE
Mailing Address - State:WA
Mailing Address - Zip Code:98815-9741
Mailing Address - Country:US
Mailing Address - Phone:509-393-0951
Mailing Address - Fax:
Practice Address - Street 1:124 COTTAGE AVE
Practice Address - Street 2:
Practice Address - City:CASHMERE
Practice Address - State:WA
Practice Address - Zip Code:98815-1002
Practice Address - Country:US
Practice Address - Phone:509-393-0951
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-07-16
Last Update Date:2013-07-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMA60271075225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist