Provider Demographics
NPI:1174234413
Name:LOREMAN, JOBETH RAE (LMT)
Entity type:Individual
Prefix:
First Name:JOBETH
Middle Name:RAE
Last Name:LOREMAN
Suffix:
Gender:F
Credentials:LMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8519 13TH PL NE
Mailing Address - Street 2:
Mailing Address - City:LAKE STEVENS
Mailing Address - State:WA
Mailing Address - Zip Code:98258-2491
Mailing Address - Country:US
Mailing Address - Phone:425-346-9573
Mailing Address - Fax:
Practice Address - Street 1:9327 4TH ST NE STE 5
Practice Address - Street 2:
Practice Address - City:LAKE STEVENS
Practice Address - State:WA
Practice Address - Zip Code:98258-1630
Practice Address - Country:US
Practice Address - Phone:425-512-9212
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-12-07
Last Update Date:2022-12-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMA00016122225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist