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General NPI Number Information
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NPI Number | 1396268389
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Entity Type | Organization
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Legal Business Name | FLOURISH WELLNESS LLC
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Dates
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Enumeration Date | 07/20/2017
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Last Update Date | 07/20/2017
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Provider Practice Location Address
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Address Line | 9327 4TH ST NE STE 6
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City | LAKE STEVENS
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State | WA
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Zip | 98258-1630
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Country | US
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Telephone | 425-407-8914
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Fax |
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Provider Business Mailing Address
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Address Line | 1831 82ND DR NE
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City | LAKE STEVENS
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State | WA
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Zip | 98258-6468
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Country | US
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Telephone | 425-407-8914
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | MS. CARRIE LYNN HUTCHINSON
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Credential | LMP
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Telephone | 425-407-8914
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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 | MA60769478
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License Number State | WA
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