MEDICARE: FLOURISH WELLNESS LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	225700000X	Massage Therapist	MA60769478	WA

General Provider Information

NPI Number	:	1396268389
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	FLOURISH WELLNESS LLC

Provider Business Mailing Address
First Line	:	1831 82ND DR NE
Second Line	:
City	:	LAKE STEVENS
State	:	WA
Zip	:	98258-6468
Country	:	US
Telephone Number	:	425-407-8914
Fax Number	:

Provider Business Practice Location Address
First Line	:	9327 4TH ST NE STE 6
Second Line	:
City	:	LAKE STEVENS
State	:	WA
Zip	:	98258-1630
Country	:	US
Telephone Number	:	425-407-8914
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	MS. CARRIE LYNN HUTCHINSON
Credential	:	LMP
Telephone Number	:	425-407-8914

Provider Enumeration Date	:	07/20/2017
Last Update Date	:	07/20/2017

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Directions to “FLOURISH WELLNESS LLC ” Practice Location

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