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General NPI Number Information
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NPI Number | 1316403975
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Entity Type | Organization
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Legal Business Name | MOUNTAIN VIEW MASSAGE & BODYWORK
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Dates
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Enumeration Date | 02/19/2019
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Last Update Date | 02/19/2019
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Provider Practice Location Address
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Address Line | 400 E PIONEER STE 202
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City | PUYALLUP
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State | WA
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Zip | 98372-3257
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Country | US
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Telephone | 406-531-3526
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Fax | 253-375-6688
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Provider Business Mailing Address
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Address Line | 9215 219TH STREET CT E
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City | GRAHAM
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State | WA
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Zip | 98338-9290
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Country | US
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Telephone | 406-531-3526
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | BETHANY J ERICKSON
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Credential |
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Telephone | 406-531-3526
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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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