Individual provider · Type 1 NPI

Jennifer Lynne Waggoner, LMP

Massage Therapist · Vancouver, WA

NPI number 1770788853 Active

Practice location

111 W 39th St
Vancouver, WA 98660-1974

Call (360) 635-8284 Map

Mailing address

30919 NE Spring Hill Rd
Yacolt, WA 98675-3004

Specialties and licenses

TaxonomyCodeLicense
Massage Therapist Primary 225700000XMA00023736 (WA)

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.

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About NPI 1770788853

Jennifer Lynne Waggoner, LMP's National Provider Identifier is 1770788853, issued on Jun 18, 2007. The primary taxonomy on file is Massage Therapist (225700000X), and the practice location is in Vancouver, WA. The record was last updated on Jul 8, 2007.