Healthcare Provider Details

I. General information

NPI: 1689476327
Provider Name (Legal Business Name): PHILIP BEBER
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/25/2025
Last Update Date: 03/25/2025
Certification Date: 03/25/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3320 W MCGRAW ST STE 4
SEATTLE WA
98199-3241
US

IV. Provider business mailing address

6024 3RD AVE NW
SEATTLE WA
98107-2104
US

V. Phone/Fax

Practice location:
  • Phone: 206-283-9910
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225700000X
TaxonomyMassage Therapist
License NumberMA61659242
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: