Provider Demographics
NPI:1265590772
Name:OAK, JEANNE LARAYNE (LMP LICENCE MASSAGE)
Entity type:Individual
Prefix:
First Name:JEANNE
Middle Name:LARAYNE
Last Name:OAK
Suffix:
Gender:F
Credentials:LMP LICENCE MASSAGE
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:263 RAINIER AVE SOUTH 208
Mailing Address - Street 2:
Mailing Address - City:RENTON
Mailing Address - State:WA
Mailing Address - Zip Code:98057
Mailing Address - Country:US
Mailing Address - Phone:425-271-2626
Mailing Address - Fax:425-271-2626
Practice Address - Street 1:263 RAINIER AVE SO 208
Practice Address - Street 2:
Practice Address - City:RENTON
Practice Address - State:WA
Practice Address - Zip Code:98057
Practice Address - Country:US
Practice Address - Phone:425-271-2626
Practice Address - Fax:425-271-2626
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-05
Last Update Date:2019-11-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMA00012102225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist