Provider Demographics
NPI:1841755691
Name:FOSTER, JOLIE ANN (LAC)
Entity type:Individual
Prefix:MISS
First Name:JOLIE
Middle Name:ANN
Last Name:FOSTER
Suffix:
Gender:F
Credentials:LAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2715 SUNSET LN NE UNIT 106
Mailing Address - Street 2:
Mailing Address - City:RENTON
Mailing Address - State:WA
Mailing Address - Zip Code:98056-3145
Mailing Address - Country:US
Mailing Address - Phone:425-873-6184
Mailing Address - Fax:
Practice Address - Street 1:2715 SUNSET LN NE UNIT 106
Practice Address - Street 2:
Practice Address - City:RENTON
Practice Address - State:WA
Practice Address - Zip Code:98056-3145
Practice Address - Country:US
Practice Address - Phone:425-873-6184
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-02-06
Last Update Date:2024-04-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA61501664225700000X
WA61491674171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist
No225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist