Most Relevant Information
Provider Data
| NPI Number: | 1003054651 |
| Provider Name: | CARISSA ANN JACOBSEN LMP |
| Entity Type: | Individual |
| Taxonomy Code: | 225700000X |
| Specialty: | Massage Therapist |
| License Number: | MA 60040731 |
Most Important Dates
| Enumeration Date: | 02/04/2009 |
| Last Updated: | 02/04/2009 |
Provider Practice Location
460 NE 70TH STREET
SEATTLE
WA
98115
Practice Location Phone/Fax
| Phone: | 2065224000 |
| Fax: |
Provider Mailing Location
P.O. BOX 262
N. LAKEWOOD
WA
98259
Provider Mailing Phone/Fax
| Phone: | 4254229956 |
| Fax: |