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General NPI Number Information
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NPI Number | 1154929677
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Entity Type | Organization
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Legal Business Name | ELK HILLS MASSAGE & BODYWORK
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Dates
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Enumeration Date | 10/16/2020
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Last Update Date | 10/16/2020
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Provider Practice Location Address
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Address Line | 205 CENTER ST E SUITE A
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City | EATONVILLE
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State | WA
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Zip | 98328
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Country | US
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Telephone | 253-569-4942
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Fax | 360-832-1722
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Provider Business Mailing Address
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Address Line | 7225 STRINGTOWN RD E
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City | EATONVILLE
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State | WA
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Zip | 98328-9006
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Country | US
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Telephone | 253-569-4942
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Fax | 306-832-1722
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Authorized Official
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Title or Position | OWNER
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Name | GLYNIS RIIPINEN
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Credential | LMT
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Telephone | 253-569-4942
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261Q00000X
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Taxonomy Name | Clinic/Center
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License Number |
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License Number State |
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