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General NPI Number Information
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NPI Number | 1447798699
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Entity Type | Organization
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Legal Business Name | ADVANCED MEDICAL MASSAGE
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Dates
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Enumeration Date | 02/08/2017
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Last Update Date | 02/08/2017
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Provider Practice Location Address
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Address Line | 1112 FINNEGAN WAY
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City | BELLINGHAM
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State | WA
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Zip | 98225-6622
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Country | US
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Telephone | 360-922-2777
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Fax |
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Provider Business Mailing Address
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Address Line | 5400 BELLAIRE DR
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City | BELLINGHAM
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State | WA
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Zip | 98226-9038
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | MASSAGE THERAPIST
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Name | KATHRYN BAILEY
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Credential |
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Telephone | 360-483-6505
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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 |
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License Number State |
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