Provider Demographics
NPI:1861246191
Name:STRITTMATTER, JANICE EILEEN (MA61528876)
Entity type:Individual
Prefix:
First Name:JANICE
Middle Name:EILEEN
Last Name:STRITTMATTER
Suffix:
Gender:F
Credentials:MA61528876
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11210 BRIDGEPORT WAY SW
Mailing Address - Street 2:
Mailing Address - City:LAKEWOOD
Mailing Address - State:WA
Mailing Address - Zip Code:98499-3003
Mailing Address - Country:US
Mailing Address - Phone:425-678-8763
Mailing Address - Fax:
Practice Address - Street 1:11210 BRIDGEPORT WAY SW
Practice Address - Street 2:
Practice Address - City:LAKEWOOD
Practice Address - State:WA
Practice Address - Zip Code:98499-3003
Practice Address - Country:US
Practice Address - Phone:253-505-0443
Practice Address - Fax:253-449-0510
Is Sole Proprietor?:No
Enumeration Date:2024-04-15
Last Update Date:2024-04-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMA61528876225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist