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General NPI Number Information
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NPI Number | 1003655242
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Entity Type | Organization
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Legal Business Name | MASSAGE HAVEN
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Dates
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Enumeration Date | 05/20/2024
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Last Update Date | 05/20/2024
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Provider Practice Location Address
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Address Line | 8927 W TUCANNON AVE STE 102A
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City | KENNEWICK
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State | WA
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Zip | 99336-7176
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Country | US
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Telephone | 509-948-8914
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Fax |
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Provider Business Mailing Address
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Address Line | 8927 W TUCANNON AVE STE 102A
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City | KENNEWICK
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State | WA
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Zip | 99336-7176
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Country | US
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Telephone | 509-948-8914
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Fax |
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Authorized Official
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Title or Position | MASSAGE THERAPIST
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Name | MRS. APRIL HOEGH
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Credential | LMT
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Telephone | 509-948-8914
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 225700000X
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Taxonomy Name | Massage Therapist
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License Number |
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License Number State |
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