Provider Demographics
NPI:1700584919
Name:ESPELAND, JAMIE
Entity Type:Individual
Prefix:
First Name:JAMIE
Middle Name:
Last Name:ESPELAND
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3504 FENDER DR
Mailing Address - Street 2:
Mailing Address - City:LYNNWOOD
Mailing Address - State:WA
Mailing Address - Zip Code:98087-5223
Mailing Address - Country:US
Mailing Address - Phone:425-231-5780
Mailing Address - Fax:
Practice Address - Street 1:18205 ALDERWOOD MALL PKWY STE A
Practice Address - Street 2:SUITE 404
Practice Address - City:LYNNWOOD
Practice Address - State:WA
Practice Address - Zip Code:98037
Practice Address - Country:US
Practice Address - Phone:425-231-5780
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-02-16
Last Update Date:2023-02-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist