Healthcare Provider Details

I. General information

NPI: 1588963672
Provider Name (Legal Business Name): STONEWORKS MASSAGE, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/15/2011
Last Update Date: 07/16/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3180 W CLEARWATER AVE STE F
KENNEWICK WA
99336-2767
US

IV. Provider business mailing address

3180 W CLEARWATER AVE STE F
KENNEWICK WA
99336-2767
US

V. Phone/Fax

Practice location:
  • Phone: 509-783-6677
  • Fax: 509-783-6675
Mailing address:
  • Phone: 509-783-6677
  • Fax: 509-783-6675

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225700000X
TaxonomyMassage Therapist
License Number
License Number State

VIII. Authorized Official

Name: MELANIE CAIN
Title or Position: MANAGING MEMBER
Credential:
Phone: 509-783-6677