Provider Demographics
NPI:1528133600
Name:MATINJUSSI, VALARIE MAE (LMP)
Entity type:Individual
Prefix:MS
First Name:VALARIE
Middle Name:MAE
Last Name:MATINJUSSI
Suffix:
Gender:F
Credentials:LMP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8009 SO 180TH ST
Mailing Address - Street 2:SUITE 104
Mailing Address - City:KENT
Mailing Address - State:WA
Mailing Address - Zip Code:98032
Mailing Address - Country:US
Mailing Address - Phone:425-282-0406
Mailing Address - Fax:425-282-0404
Practice Address - Street 1:8009 SO 180TH ST
Practice Address - Street 2:SUITE 104
Practice Address - City:KENT
Practice Address - State:WA
Practice Address - Zip Code:98032
Practice Address - Country:US
Practice Address - Phone:425-282-0406
Practice Address - Fax:425-282-0404
Is Sole Proprietor?:No
Enumeration Date:2006-11-22
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WARC00032767101Y00000X
WAMA00011705225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered101Y00000XBehavioral Health & Social Service ProvidersCounselor
Not Answered225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA0214068OtherLABOR & INDUSTRY