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General NPI Number Information
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NPI Number | 1518046952
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Entity Type | Organization
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Legal Business Name | MRMASSAGE,INC.
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Dates
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Enumeration Date | 11/05/2006
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 400 S 43RD ST
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City | RENTON
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State | WA
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Zip | 98055-5714
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Country | US
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Telephone | 425-656-4006
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Fax |
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Provider Business Mailing Address
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Address Line | 643 S 305TH ST
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City | FEDERAL WAY
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State | WA
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Zip | 98003-4021
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Country | US
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Telephone | 253-839-6058
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Fax | 180-066-0800
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Authorized Official
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Title or Position | PRESIDENT
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Name | MR. RONALD L. CATE
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Credential | LMP
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Telephone | 253-839-6058
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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 | MA00011107
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License Number State | WA
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