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General NPI Number Information
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NPI Number | 1447930334
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Entity Type | Organization
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Legal Business Name | VITALITY BODYWORK, LLC
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Dates
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Enumeration Date | 07/24/2023
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Last Update Date | 07/03/2025
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Provider Practice Location Address
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Address Line | 490 MADISON AVE N STE 101
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City | BAINBRIDGE ISLAND
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State | WA
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Zip | 98110-1871
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Country | US
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Telephone | 425-466-9290
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Fax |
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Provider Business Mailing Address
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Address Line | 1646 JEANNETTE PL NW
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City | BAINBRIDGE IS
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State | WA
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Zip | 98110-1655
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Country | US
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Telephone | 425-466-9290
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | SONYA BENNETT
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Credential |
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Telephone | 425-466-9290
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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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Taxonomy #2
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Taxonomy Code | 261Q00000X
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Taxonomy Name | Clinic/Center
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License Number |
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License Number State |
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