JACKLYN ROSE PETRETEE (NPI# 1255842134) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1255842134 |
| Entity Type | Individual |
| Full Name | JACKLYN ROSE PETRETEE |
| Practice Address |
24850 E Stonecrest Ave Liberty Lake WA 99019-3403 |
| Practice Telephone | 5092304630 |
| Mailing Telephone | 5092304630 |
| Enumeration Date | 2017-10-18 |
| Last Update Date | 2017-10-18 |
| Gender Code | F |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 225700000X | Massage Therapist | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
| Street Address |
24850 E STONECREST AVE |
| City | LIBERTY LAKE |
| State | WA |
| Zip Code | 99019-3403 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1194201533 | Lorena Margaret De La Rosa | Nurse Practitioner | 22820 E Appleway Ave Ste A, Liberty Lake, WA 99019 | 2018-07-18 |
| 1831641570 | Shirla Underwood | Spec/Tech, Cardiovascular | 3705 S Molter Rd, Liberty Lake, WA 99019 | 2016-10-28 |
| 1215393079 | Samuel Lionel Nelson | Chiropractor | 23801 East Appleway Ave, #110, Liberty Lake, WA 99019 | 2016-01-11 |
| 1841627601 | Noland Peterdy | Pharmacist | 1423 N Molter 727, Liberty Lake, WA 99019 | 2013-10-10 |
| 1043559446 | Phillip Wayne Harris | Reflexologist | E 23505 Appleway, Liberty Lake, WA 99019 | 2013-02-05 |
| 1710231766 | Mark Autrey | Pharmacist | 23010 E Settler Drive, Spokane, WA 99019 | 2012-10-30 |
| 1982971107 | Michele Ladd | Dental Hygienist | 22826 East Clearwater Lane, Liberty Lake, WA 99019 | 2011-11-17 |
| 1467689166 | Drostan Gregg Baker | Family Medicine | 2207 N Molter Rd Ste 203, Liberty Lake, WA 99019 | 2009-06-19 |
| 1619117959 | Joline Marie Messina | Behavioral Analyst | 1324 N Liberty Lake Rd # 193, Liberty Lake, WA 99019 | 2009-02-26 |
| 1144427964 | J. Evans, Dmd, P.s. | Dentist | 1327 N Stanford Lane, Suite B, Liberty Lake, WA 99019 | 2007-06-27 |
| Find all providers in zip 99019 | ||||
| Taxonomy Code | 225700000X |
| Grouping | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
| Classification | Massage Therapist |
| An individual trained in the manipulation of tissues (as by rubbing, stroking, kneading, or tapping) with the hand or an instrument for remedial or hygienic purposes. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1275177529 | Kristen Elizabeth Heacox | Massage Therapist | 24326 E Maxwell Ave, Liberty Lake, WA 99019-8633 | 2019-10-30 |
| 1053877563 | Lisa A Tarr | Massage Therapist | 1334 N Whitman Ln Ste 140, Liberty Lake, WA 99019-6034 | 2019-02-20 |
| 1164932158 | Cyndi Rai | Massage Therapist | 23801 E Appleway Ave Ste 220, Liberty Lake, WA 99019-9687 | 2017-10-04 |
| 1548554710 | Matthew Bryant Delker | Massage Therapist | 1017 N Homestead Dr, Liberty Lake, WA 99019-8555 | 2011-06-06 |
| 1831323344 | Staci Wixom Jacobs | Massage Therapist | 1235 N Liberty Lake Rd, Suite 106, Liberty Lake, WA 99019-7581 | 2009-05-12 |
| 1346449089 | Sedonni Kaye Jones | Massage Therapist | 21200 E Country Vista Dr Apt I202, Liberty Lake, WA 99019-7681 | 2007-07-13 |
| 1760608087 | Jennifer Janzen | Massage Therapist | 2207 N. Molter Rd., Sut. 250, Liberty Lake, WA 99109 | 2007-04-17 |
| 1700908803 | Shenae' M Dolan | Massage Therapist | 23801 E. Appleway, Liberty Lake, WA 99019 | 2007-04-06 |
| 1245871508 | Shenette Gamoyao Cross | Massage Therapist | 2207 N Molter Rd, Liberty Lake, WA 99019-7570 | 2019-10-07 |
| 1144791146 | Teagan Luckey | Massage Therapist | 2207 N Molter Rd Ste 250, Liberty Lake, WA 99019-7582 | 2018-12-17 |
| Find all providers in LIBERTY LAKE | ||||
| City | LIBERTY LAKE |
| Zip Code | 99019 |
Please comment or provide details below to improve the information on JACKLYN ROSE PETRETEE.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.