Provider Demographics
NPI:1548544224
Name:JAKEMAN, CATHERINE NICOLE (LMT, PA-C)
Entity type:Individual
Prefix:
First Name:CATHERINE
Middle Name:NICOLE
Last Name:JAKEMAN
Suffix:
Gender:F
Credentials:LMT, PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:5218 S PUGET SOUND AVE
Mailing Address - Street 2:
Mailing Address - City:TACOMA
Mailing Address - State:WA
Mailing Address - Zip Code:98409-4317
Mailing Address - Country:US
Mailing Address - Phone:253-861-8200
Mailing Address - Fax:888-864-8563
Practice Address - Street 1:5218 S PUGET SOUND AVE
Practice Address - Street 2:
Practice Address - City:TACOMA
Practice Address - State:WA
Practice Address - Zip Code:98409-4317
Practice Address - Country:US
Practice Address - Phone:253-861-8200
Practice Address - Fax:253-473-2806
Is Sole Proprietor?:Yes
Enumeration Date:2011-09-29
Last Update Date:2024-06-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA00018196225700000X
WA60726547363AM0700X, 363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantGroup - Multi-Specialty
No225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist
No363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical