Healthcare Provider Details

I. General information

NPI: 1588443592
Provider Name (Legal Business Name): MASSAGE ME LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/28/2023
Last Update Date: 05/06/2024
Certification Date: 05/06/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5602 176TH ST E STE G102103
PUYALLUP WA
98375-9307
US

IV. Provider business mailing address

20624 73RD AVENUE CT E
SPANAWAY WA
98387-5300
US

V. Phone/Fax

Practice location:
  • Phone: 253-847-7646
  • Fax: 253-271-0445
Mailing address:
  • Phone: 253-314-1506
  • Fax: 253-271-0445

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code225700000X
TaxonomyMassage Therapist
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code261Q00000X
TaxonomyClinic/Center
License Number
License Number State

VIII. Authorized Official

Name: GEORGINA HOLLAND
Title or Position: OWNER
Credential:
Phone: 253-314-1506