Individual
JOLEEN DENISE BLACK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LMT
Contact information
Practice address
8827 31ST AVE SW # 1, SEATTLE, WA 98126-3718
(206) 841-4031
(206) 973-2747
Mailing address
8827 31ST AVE SW, SEATTLE, WA 98126-3718
(206) 841-4031
(206) 973-2747
Taxonomy
Speciality
Code
Description
License number
State
171100000X
Acupuncturist
Primary
AC60530881
WA
225700000X
Massage Therapist
MA00020122
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
219893
LABOR AND INDUSTRY
WA
Enumeration date
05/24/2007
Last updated
05/13/2020
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