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General NPI Number Information
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NPI Number | 1225536428
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Entity Type | Organization
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Legal Business Name | NW ORTHOPAEDIC MASSAGE
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Dates
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Enumeration Date | 01/23/2018
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Last Update Date | 01/23/2018
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Provider Practice Location Address
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Address Line | 7500 212TH ST SW STE 101
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City | EDMONDS
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State | WA
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Zip | 98026-7614
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Country | US
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Telephone | 425-776-6966
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Fax | 425-776-6969
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Provider Business Mailing Address
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Address Line | 7500 212TH ST SW STE 101
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City | EDMONDS
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State | WA
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Zip | 98026-7614
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Country | US
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Telephone | 425-776-6966
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Fax | 425-776-6969
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Authorized Official
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Title or Position | CEO
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Name | MAUREEN ROSE PARKER
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Credential | MS, ATC/L, LMT
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Telephone | 425-776-6966
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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 | MA00022740
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License Number State | WA
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