Jeff Lee Sisco, LMP

NPI #1164631248 in Bonney Lake, Washington

Provider Information

NPI Number: 1164631248
Entity Type: Individual
Name: Jeff Lee Sisco, LMP
Gender: Not Specified
Sole Proprietor: Yes
Primary Specialty: Massage Therapist
Credential: LMP
Enumeration Date: May 22, 2007
Last Updated: Jul 9, 2007

Practice Location

Address: 21157 STATE ROUTE 410
City: Bonney Lake
State: Washington
ZIP Code: 98390
Phone: (253) 862-8590

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Massage Therapist	225700000X	Primary

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