MRS. JOLEEN MICHELLE BACON LMP NPI 1174678098

NPI Information

NPI: 1174678098
Provider Name: MRS. JOLEEN MICHELLE BACON, LMP
Classification: Massage Therapist - 225700000X
Entity Type: Individual
Address:
4620 200TH ST SW
SUITE C
LYNNWOOD, WA
ZIP 98036
Phone: (425) 697-5144
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MRS. Joleen Michelle Bacon, LMP is a massage therapist in Lynnwood, WA. The provider is an individual trained in the manipulation of tissues (as by rubbing, stroking, kneading, or tapping) with the hand or an instrument for remedial or hygienic purposes. MRS. Joleen Michelle Bacon, LMP NPI is 1174678098. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a female.

The provider's business location address is:

4620 200TH ST SW
SUITE C
LYNNWOOD, WA
ZIP 98036-607
Phone: (425) 697-5144
Fax: (425) 778-0824

The enumeration date for this NPI number is 1/23/2007 and was last updated on 7/8/2007.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	225700000X	Massage Therapist		MA00011700	WASHINGTON	Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	8405BA	OTHER	WASHINGTON	REGENCE
2	146955	OTHER	WASHINGTON	LABOR AND INDUSTRIES

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 5/5/2024

NPI Synchronization or Removal

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