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Individual

MRS. JESSICA D SUNDAHL

Active
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Individual

MRS. JESSICA D SUNDAHL

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
L.M.P

Taxonomy

Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
MA00016460
WA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
0007827360
AETNA PROVIDER NUMBER
WA
01
0158989
LABOR AND INDUSTRIES
WA
01
254423100000
PREMERA PROVIDER NUMBER
WA
01
4342TI
REGENCECARE ID NUMBER
WA
01
6021925760010001
UBI BUSINESS
WA
01
MA00016460
LICENSE FOR MASSAGE
WA
Enumeration date
01/09/2007
Last updated
10/08/2013
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