Provider Demographics
NPI:1184809972
Name:JOFRAN ENTERPRISES, INC.
Entity type:Organization
Organization Name:JOFRAN ENTERPRISES, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:VICE-PRESIDENT
Authorized Official - Prefix:MS
Authorized Official - First Name:JOAN
Authorized Official - Middle Name:E
Authorized Official - Last Name:COLE
Authorized Official - Suffix:
Authorized Official - Credentials:LMP
Authorized Official - Phone:360-385-5068
Mailing Address - Street 1:1411 CORONA ST
Mailing Address - Street 2:
Mailing Address - City:PORT TOWNSEND
Mailing Address - State:WA
Mailing Address - Zip Code:98368-4807
Mailing Address - Country:US
Mailing Address - Phone:360-385-5068
Mailing Address - Fax:
Practice Address - Street 1:1411 CORONA ST
Practice Address - Street 2:
Practice Address - City:PORT TOWNSEND
Practice Address - State:WA
Practice Address - Zip Code:98368-4807
Practice Address - Country:US
Practice Address - Phone:360-385-5068
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-12-31
Last Update Date:2008-06-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMA00016328225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage TherapistGroup - Single Specialty