Individual
JENNIFER DIANE LOPEZ
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PT
Contact information
Practice address
325 9TH AVE, SEATTLE, WA 98104-2420
(206) 744-3000
Mailing address
4251 S 172ND ST, SEATAC, WA 98188-3632
(213) 999-0215
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
60662056
WA
Other
Enumeration date
08/08/2016
Last updated
04/02/2021
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