Healthcare Provider Details

I. General information

NPI: 1497901508
Provider Name (Legal Business Name): RICHARD ALFRED ARIES LMP
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/09/2008
Last Update Date: 08/09/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8250 LATONA AVE NE
SEATTLE WA
98115-4055
US

IV. Provider business mailing address

8250 LATONA AVE NE
SEATTLE WA
98115-4055
US

V. Phone/Fax

Practice location:
  • Phone: 206-528-2954
  • Fax: 206-522-4749
Mailing address:
  • Phone: 206-528-2954
  • Fax: 206-522-4749

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225700000X
TaxonomyMassage Therapist
License NumberMA 00003648
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: