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General NPI Number Information
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NPI Number | 1235664004
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Entity Type | Organization
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Legal Business Name | GAMMA BODYWORKS LLC
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Dates
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Enumeration Date | 04/28/2017
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Last Update Date | 04/28/2017
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Provider Practice Location Address
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Address Line | 419 QUEEN ANNE AVE N STE 106
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City | SEATTLE
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State | WA
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Zip | 98109-4539
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Country | US
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Telephone | 206-399-8568
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Fax |
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Provider Business Mailing Address
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Address Line | 419 QUEEN ANNE AVE N STE 106
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City | SEATTLE
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State | WA
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Zip | 98109-4539
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Country | US
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Telephone | 206-399-8568
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | MEGAN JONES
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Credential |
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Telephone | 296-399-8568
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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 | MA 60040444
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License Number State | WA
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