Provider Demographics
NPI:1053542167
Name:CEA, JENNIFER ANN (LMT)
Entity type:Individual
Prefix:
First Name:JENNIFER
Middle Name:ANN
Last Name:CEA
Suffix:
Gender:F
Credentials:LMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1529 QUEEN ANNE AVE N APT 100
Mailing Address - Street 2:
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98109-2878
Mailing Address - Country:US
Mailing Address - Phone:206-399-8569
Mailing Address - Fax:844-213-7091
Practice Address - Street 1:1529 QUEEN ANNE AVE N APT 100
Practice Address - Street 2:
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98109-2878
Practice Address - Country:US
Practice Address - Phone:206-719-3759
Practice Address - Fax:844-213-7091
Is Sole Proprietor?:Yes
Enumeration Date:2009-08-06
Last Update Date:2023-01-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMA00024780225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist