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General NPI Number Information
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NPI Number | 1295800399
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Entity Type | Organization
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Legal Business Name | KNEADING HANDS MASSAGE THERAPY, LLC
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Dates
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Enumeration Date | 11/22/2006
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 17066 BEATON RD SE SUITE 170
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City | MONROE
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State | WA
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Zip | 98272-1002
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Country | US
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Telephone | 360-863-0960
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Fax | 360-863-8710
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Provider Business Mailing Address
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Address Line | 17066 BEATON RD SE SUITE 170
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City | MONROE
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State | WA
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Zip | 98272-1002
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Country | US
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Telephone | 360-863-0960
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Fax | 360-863-8710
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Authorized Official
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Title or Position | OWNER
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Name | MRS. SHARON LOUISE ZYLSTRA
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Credential | LMP
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Telephone | 360-863-0960
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 174400000X
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Taxonomy Name | Specialist
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License Number | MA00019954
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License Number State | WA
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Taxonomy #2
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Taxonomy Code | 174400000X
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Taxonomy Name | Specialist
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License Number | MA00020051
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License Number State | WA
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Taxonomy #3
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Taxonomy Code | 174400000X
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Taxonomy Name | Specialist
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License Number | MA00021601
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License Number State | WA
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Taxonomy #4
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Taxonomy Code | 174400000X
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Taxonomy Name | Specialist
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License Number | MA00020587
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License Number State | WA
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Taxonomy #5
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Taxonomy Code | 174400000X
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Taxonomy Name | Specialist
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License Number | MA00010802
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License Number State | WA
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