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1235980210
GREY LUNA JACK RIVERSTONE
REDMOND, WA
NPI
1235980210
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Former Name
JENNIFER ANNE SACKETT
Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
225700000X Massage Therapist
(Licence: WA MA00023063)
Enumeration Date
2024-03-28
Last Update Date
2024-03-28
Business Address
GREY LUNA JACK RIVERSTONE
16398 NE 85TH ST STE 100
REDMOND, WA 98052-3555
Phone number: 425-636-1569
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Mailing Address
GREY LUNA JACK RIVERSTONE
21040 NE WOODINVILLE DUVALL RD
WOODINVILLE, WA 98077-7748
Phone number: 425-505-7747
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