Provider Demographics
NPI:1891844874
Name:WEBER, JOYCE A (LMP)
Entity type:Individual
Prefix:MRS
First Name:JOYCE
Middle Name:A
Last Name:WEBER
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 1:821 HARVEY RD STE A
Mailing Address - Street 2:
Mailing Address - City:AUBURN
Mailing Address - State:WA
Mailing Address - Zip Code:98002-4225
Mailing Address - Country:US
Mailing Address - Phone:253-315-0317
Mailing Address - Fax:253-833-4642
Practice Address - Street 1:821 HARVEY RD STE A
Practice Address - Street 2:
Practice Address - City:AUBURN
Practice Address - State:WA
Practice Address - Zip Code:98002-4225
Practice Address - Country:US
Practice Address - Phone:253-315-0317
Practice Address - Fax:253-833-4642
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-09
Last Update Date:2009-02-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMA00014568225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist