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General NPI Number Information
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NPI Number | 1447790522
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Entity Type | Organization
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Legal Business Name | KNEADING BODYWORK
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Dates
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Enumeration Date | 03/08/2017
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Last Update Date | 03/08/2017
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Provider Practice Location Address
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Address Line | 1409 FRANKLIN ST SUITE 103
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City | VANCOUVER
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State | WA
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Zip | 98660-2899
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Country | US
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Telephone | 360-718-7603
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Fax | 360-852-8043
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Provider Business Mailing Address
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Address Line | 1409 FRANKLIN ST SUITE 103
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City | VANCOUVER
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State | WA
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Zip | 98660-2899
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Country | US
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Telephone | 360-718-7603
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Fax | 360-852-8043
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Authorized Official
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Title or Position | OWNER
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Name | RICHELLE MCMANN
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Credential |
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Telephone | 360-718-7603
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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 | WA
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