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General NPI Number Information
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NPI Number | 1235274374
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Entity Type | Organization
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Legal Business Name | MARQUIS MASSAGE GROUP, LLC
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Dates
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Enumeration Date | 02/20/2007
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 27116 167TH PL SE SUITE 114
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City | COVINGTON
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State | WA
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Zip | 98042-7341
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Country | US
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Telephone | 253-630-6614
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Fax | 253-630-6624
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Provider Business Mailing Address
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Address Line | 12932 SE KENT KANGLEY RD SUITE 438
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City | KENT
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State | WA
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Zip | 98030-7940
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Country | US
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Telephone | 425-392-1814
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Fax | 425-392-1813
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Authorized Official
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Title or Position | OWNER
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Name | ADRIEN ZEUMAULT
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Credential |
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Telephone | 425-392-1814
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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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