Healthcare Provider Details

I. General information

NPI: 1902176589
Provider Name (Legal Business Name): NATURAL BODY WORKS
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/12/2012
Last Update Date: 01/12/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

106 E 9TH ST
VANCOUVER WA
98660-3269
US

IV. Provider business mailing address

106 E 9TH ST
VANCOUVER WA
98660-3269
US

V. Phone/Fax

Practice location:
  • Phone: 360-513-7531
  • Fax: 360-694-9726
Mailing address:
  • Phone: 360-513-7531
  • Fax: 360-694-9726

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code174400000X
TaxonomySpecialist
License NumberMA00021648
License Number StateWA

VIII. Authorized Official

Name: SHANNA M ARNO
Title or Position: MASSAGE THERAPIST, OWNER, OPERATOR
Credential: LMP
Phone: 360-513-7531