Individual
CARISSA ANN JACOBSEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LMP
Contact information
Practice address
460 NE 70TH STREET, SEATTLE, WA 98115
(206) 522-4000
Mailing address
P.O. BOX 262, N. LAKEWOOD, WA 98259
(425) 422-9956
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
MA 60040731
WA
Other
Enumeration date
02/04/2009
Last updated
02/04/2009
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