Healthcare Provider Details

I. General information

NPI: 1619881372
Provider Name (Legal Business Name): KEITH MUSCHEK
Entity Type: Individual
Gender:
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/30/2026
Last Update Date: 09/30/2026
Certification Date: 09/30/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9909 224TH ST E
GRAHAM WA
98338-7086
US

IV. Provider business mailing address

7926 193RD STREET CT E
SPANAWAY WA
98387-5090
US

V. Phone/Fax

Practice location:
  • Phone: 253-271-0338
  • Fax:
Mailing address:
  • Phone: 253-279-6752
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225700000X
TaxonomyMassage Therapist
License Number70168646
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: