=====================================================
General NPI Number Information
=====================================================
NPI Number | 1184581019
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | BETHANY MEGAN GRACE CHAU LMT
-----------------------------------------------------
Gender | Female
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 01/05/2026
-----------------------------------------------------
Last Update Date | 01/05/2026
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 405 BLACK HILLS LN SW BLDG 405
-----------------------------------------------------
City | OLYMPIA
-----------------------------------------------------
State | WA
-----------------------------------------------------
Zip | 98502-8661
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 425-202-5210
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 16236 84TH CT SE
-----------------------------------------------------
City | YELM
-----------------------------------------------------
State | WA
-----------------------------------------------------
Zip | 98597-8401
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 425-202-5210
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 225700000X
-----------------------------------------------------
Taxonomy Name | Massage Therapist
-----------------------------------------------------
License Number | MASS.MA60695112
-----------------------------------------------------
License Number State | WA
-----------------------------------------------------