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General NPI Number Information
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NPI Number | 1144879453
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Entity Type | Organization
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Legal Business Name | ROSE ROCK BODYWORK
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Dates
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Enumeration Date | 09/09/2019
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Last Update Date | 09/09/2019
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Provider Practice Location Address
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Address Line | 2200 BROADWAY ST STE C
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City | VANCOUVER
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State | WA
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Zip | 98663-3255
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Country | US
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Telephone | 360-890-9794
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Fax | 136-078-5238
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Provider Business Mailing Address
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Address Line | 2200 BROADWAY ST STE C
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City | VANCOUVER
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State | WA
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Zip | 98663-3255
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Country | US
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Telephone | 360-890-9794
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Fax | 136-078-5238
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Authorized Official
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Title or Position | OWNER
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Name | JESSICA RENEE SANCHEZ-HARPER
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Credential |
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Telephone | 503-488-0761
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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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