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General NPI Number Information
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NPI Number | 1245502749
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Entity Type | Organization
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Legal Business Name | SEATTLE THERAPEUTICS PS
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Dates
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Enumeration Date | 01/31/2012
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Last Update Date | 01/17/2013
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Provider Practice Location Address
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Address Line | 701 N 36TH ST STE #420
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City | SEATTLE
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State | WA
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Zip | 98103-8868
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Country | US
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Telephone | 206-547-5677
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Fax | 206-547-5598
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Provider Business Mailing Address
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Address Line | 701 N 36TH ST STE #420
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City | SEATTLE
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State | WA
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Zip | 98103-8868
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Country | US
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Telephone | 206-547-5677
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Fax | 206-547-5598
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Authorized Official
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Title or Position | D.C
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Name | MICHAEL D BOURBONNAIS
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Credential | DC
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Telephone | 206-547-5677
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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 | MA60159887
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License Number State | WA
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Taxonomy #2
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Taxonomy Code | 172M00000X
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Taxonomy Name | Mechanotherapist
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License Number | MA00019319
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License Number State | WA
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Taxonomy #3
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Taxonomy Code | 225700000X
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Taxonomy Name | Massage Therapist
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License Number | MA00012837
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License Number State | WA
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Taxonomy #4
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Taxonomy Code | 172M00000X
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Taxonomy Name | Mechanotherapist
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License Number | MA60247265
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License Number State | WA
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Taxonomy #5
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Taxonomy Code | 225700000X
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Taxonomy Name | Massage Therapist
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License Number | MA60258024
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License Number State | WA
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Taxonomy #6
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Taxonomy Code | 174400000X
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Taxonomy Name | Specialist
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License Number | MA00023264
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License Number State | WA
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Taxonomy #7
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Taxonomy Code | 225700000X
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Taxonomy Name | Massage Therapist
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License Number | MA60303918
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License Number State | WA
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Taxonomy #8
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Taxonomy Code | 225700000X
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Taxonomy Name | Massage Therapist
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License Number | MA00018784
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License Number State | WA
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