Healthcare Provider Details

I. General information

NPI: 1700203478
Provider Name (Legal Business Name): ARIANA BEVIN HOARD LMT
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: ARIANA BEVIN KNESEBECK LMT

II. Dates (important events)

Enumeration Date: 03/19/2014
Last Update Date: 09/16/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1202 E PINE ST UNIT 103
SEATTLE WA
98122-3929
US

IV. Provider business mailing address

3601 FREMONT AVE N STE 209
SEATTLE WA
98103-8753
US

V. Phone/Fax

Practice location:
  • Phone: 206-853-1540
  • Fax:
Mailing address:
  • Phone: 206-853-1540
  • Fax: 253-856-8754

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code172M00000X
TaxonomyMechanotherapist
License NumberMA 60449594
License Number StateWA
# 2
Primary TaxonomyY
Taxonomy Code225700000X
TaxonomyMassage Therapist
License NumberMA60449594
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: