Individual
JAZMIN L LOPEZ
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PT
Contact information
Practice address
26545 MAPLE VALLEY BLACK DIAMOND RD SE STE K160, MAPLE VALLEY, WA 98038-8391
(425) 578-7211
(425) 578-7212
Mailing address
790 REMINGTON BLVD, BOLINGBROOK, IL 60440-4909
(425) 430-0710
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
PT60835321
WA
Other
Enumeration date
04/25/2018
Last updated
04/25/2018
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