Healthcare Provider Details

I. General information

NPI: 1760346548
Provider Name (Legal Business Name): ALPENGLOW BODYWORK
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/15/2025
Last Update Date: 12/15/2025
Certification Date: 12/15/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9358 CALIFORNIA AVE SW
SEATTLE WA
98136-2821
US

IV. Provider business mailing address

9358 CALIFORNIA AVE SW
SEATTLE WA
98136-2821
US

V. Phone/Fax

Practice location:
  • Phone: 206-949-0314
  • Fax:
Mailing address:
  • Phone: 206-949-0314
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225700000X
TaxonomyMassage Therapist
License Number
License Number State

VIII. Authorized Official

Name: MATHEW RUSSELL
Title or Position: OWNER/PRACTITIONER
Credential: LMT
Phone: 206-949-0314