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Contact Information

JILLIAN M BOUCEK, LMP
19030 108TH AVE SE
STE 1
RENTON, WA98055-6425
 Phone: 425-282-5048
 Fax:
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Mechanotherapist

172M00000X
Indicates primary specialty

NPI Profile & details for JILLIAN M BOUCEK · (Female)

NPI # 1275757197
Status Active
Credentials LMP (Licensed Medical Practitioner)
Entity Individual
Enumeration date 04/12/2007
Last updated 01/20/2009 - About 17 years ago
Sole proprietor 1 Yes
Identifiers
  • WA License # MA00011013
Hospital affiliation(s) Not Available
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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