Healthcare Provider Details

I. General information

NPI: 1316862477
Provider Name (Legal Business Name): LOVE EVAN HILLS LMT
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/10/2026
Last Update Date: 08/10/2026
Certification Date: 08/10/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6046 PORTAL WAY STE 102
FERNDALE WA
98248-7829
US

IV. Provider business mailing address

2722 FRANKLIN ST
BELLINGHAM WA
98225-2602
US

V. Phone/Fax

Practice location:
  • Phone: 360-778-1171
  • Fax:
Mailing address:
  • Phone: 720-415-2904
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225700000X
TaxonomyMassage Therapist
License NumberMASS.MA.70134482
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: