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General NPI Number Information
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NPI Number | 1154239655
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Entity Type | Organization
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Legal Business Name | THE PINK BUDDHA LLC
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Dates
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Enumeration Date | 08/28/2026
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Last Update Date | 08/28/2026
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Provider Practice Location Address
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Address Line | 17 2ND ST E STE 209
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City | KALISPELL
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State | MT
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Zip | 59901-4500
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Country | US
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Telephone | 406-885-2974
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 11291
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City | KALISPELL
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State | MT
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Zip | 59904-4291
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Country | US
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Telephone | 406-885-2974
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Fax |
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Authorized Official
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Title or Position | MANAGING MEMBER
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Name | NICOLE DANAE
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Credential | LMT, CMLDT, CNMT
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Telephone | 406-885-2974
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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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