Healthcare Provider Details

I. General information

NPI: 1164661781
Provider Name (Legal Business Name): HAYEK MASSAGE INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/05/2009
Last Update Date: 04/14/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3209 E 57TH AVE STE F
SPOKANE WA
99223-7040
US

IV. Provider business mailing address

3209 E 57TH AVE STE F
SPOKANE WA
99223-7040
US

V. Phone/Fax

Practice location:
  • Phone: 509-448-9398
  • Fax: 509-448-3823
Mailing address:
  • Phone: 509-448-9398
  • Fax: 509-448-3823

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225700000X
TaxonomyMassage Therapist
License Number602693925
License Number StateWA

VIII. Authorized Official

Name: KRISTAL HAYEK
Title or Position: OWNER
Credential:
Phone: 509-448-9398