Provider Demographics
NPI:1336996792
Name:FREEMAN, JOANNE LOUISE (LMT)
Entity type:Individual
Prefix:MRS
First Name:JOANNE
Middle Name:LOUISE
Last Name:FREEMAN
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 1:15605 30TH AVE SE
Mailing Address - Street 2:
Mailing Address - City:MILL CREEK
Mailing Address - State:WA
Mailing Address - Zip Code:98012-5892
Mailing Address - Country:US
Mailing Address - Phone:425-287-4659
Mailing Address - Fax:
Practice Address - Street 1:15605 30TH AVE SE
Practice Address - Street 2:
Practice Address - City:MILL CREEK
Practice Address - State:WA
Practice Address - Zip Code:98012-5892
Practice Address - Country:US
Practice Address - Phone:425-287-4659
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-05-03
Last Update Date:2024-05-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMA61150271225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage TherapistGroup - Single Specialty