Individual
MR. JAN GELDERLOOS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LMT, NMT
Contact information
Practice address
4101 W MARGINAL WAY SW, A4, SEATTLE, WA 98106-1282
(206) 935-7526
Mailing address
PO BOX 48142, SEATTLE, WA 98148-0142
(206) 935-7526
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
MA 00006764
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0206602
LABOR AND INDUSTRIES, WA
WA
Enumeration date
12/23/2009
Last updated
12/23/2009
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