Provider Demographics
NPI:1801976436
Name:ALBAN VARELA, JENNIFER R (LMP)
Entity type:Individual
Prefix:MS
First Name:JENNIFER
Middle Name:R
Last Name:ALBAN VARELA
Suffix:
Gender:F
Credentials:LMP
Other - Prefix:
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Other - Middle Name:
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Mailing Address - Street 1:1140 A 140TH AVE NE
Mailing Address - Street 2:
Mailing Address - City:BELLEVILLE
Mailing Address - State:WA
Mailing Address - Zip Code:98005
Mailing Address - Country:US
Mailing Address - Phone:425-957-0761
Mailing Address - Fax:425-957-1156
Practice Address - Street 1:1140 A 140TH AVE NE
Practice Address - Street 2:
Practice Address - City:BELLEVILLE
Practice Address - State:WA
Practice Address - Zip Code:98005
Practice Address - Country:US
Practice Address - Phone:425-957-0761
Practice Address - Fax:425-957-1156
Is Sole Proprietor?:No
Enumeration Date:2006-10-17
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
WAMA00011116225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist