Provider Demographics
NPI:1811705379
Name:SENAT, JASON (MASSMA61218037)
Entity type:Individual
Prefix:
First Name:JASON
Middle Name:
Last Name:SENAT
Suffix:
Gender:M
Credentials:MASSMA61218037
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8227 117TH AVE SE
Mailing Address - Street 2:
Mailing Address - City:NEWCASTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98056-1778
Mailing Address - Country:US
Mailing Address - Phone:845-459-7564
Mailing Address - Fax:
Practice Address - Street 1:1 LAKE BELLEVUE DR STE 208
Practice Address - Street 2:
Practice Address - City:BELLEVUE
Practice Address - State:WA
Practice Address - Zip Code:98005-2417
Practice Address - Country:US
Practice Address - Phone:845-459-7564
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-12-30
Last Update Date:2024-12-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMA61218037225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist