Individual
BETHANY JORGENSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LMP
Contact information
Practice address
5410 PONDEROSA BLVD NE, HANSVILLE, WA 98340-8716
(206) 852-9700
Mailing address
5410 PONDEROSA BLVD NE, HANSVILLE, WA 98340-8716
(206) 852-9700
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
MA00015151
WA
Other
Enumeration date
09/19/2010
Last updated
09/19/2010
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