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General NPI Number Information
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NPI Number | 1386932713
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Entity Type | Organization
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Legal Business Name | AAH SPA, LLC
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Dates
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Enumeration Date | 07/19/2011
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Last Update Date | 07/19/2011
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Provider Practice Location Address
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Address Line | 510 E WOODIN AVE
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City | CHELAN
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State | WA
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Zip | 98816-9148
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Country | US
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Telephone | 509-470-4895
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Fax |
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Provider Business Mailing Address
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Address Line | 510 E WOODIN AVE
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City | CHELAN
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State | WA
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Zip | 98816-9148
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Country | US
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Telephone | 509-470-4895
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | MRS. LINDA F ODELL
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Credential |
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Telephone | 360-471-0948
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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 | MA60091815
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License Number State | WA
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