Provider Demographics
NPI:1427749886
Name:JEN'S ALOHA MASSAGE
Entity type:Organization
Organization Name:JEN'S ALOHA MASSAGE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CO-OWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:JENNIFER
Authorized Official - Middle Name:LYNETTE
Authorized Official - Last Name:MORRILL
Authorized Official - Suffix:
Authorized Official - Credentials:LMP
Authorized Official - Phone:509-953-0564
Mailing Address - Street 1:PO BOX 1183
Mailing Address - Street 2:
Mailing Address - City:DEER PARK
Mailing Address - State:WA
Mailing Address - Zip Code:99006-1183
Mailing Address - Country:US
Mailing Address - Phone:509-312-4820
Mailing Address - Fax:509-931-0449
Practice Address - Street 1:206 W 1ST ST
Practice Address - Street 2:SUITE C
Practice Address - City:DEER PARK
Practice Address - State:WA
Practice Address - Zip Code:99006
Practice Address - Country:US
Practice Address - Phone:509-312-4820
Practice Address - Fax:509-931-0449
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-05-17
Last Update Date:2023-05-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage TherapistGroup - Single Specialty