Healthcare Provider Details

I. General information

NPI: 1467722108
Provider Name (Legal Business Name): URBAN HEALING ARTS STUDIO, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/11/2012
Last Update Date: 01/11/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8119 STONE AVE N
SEATTLE WA
98103-4414
US

IV. Provider business mailing address

8113 STONE AVE N
SEATTLE WA
98103-4414
US

V. Phone/Fax

Practice location:
  • Phone: 888-718-7226
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225700000X
TaxonomyMassage Therapist
License NumberMA00021474
License Number StateWA

VIII. Authorized Official

Name: MRS. JULIE JENKINS
Title or Position: OWNER
Credential:
Phone: 206-226-5533