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General NPI Number Information
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NPI Number | 1558173872
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Entity Type | Organization
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Legal Business Name | PURE ESCAPE SPA
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Dates
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Enumeration Date | 01/23/2025
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Last Update Date | 01/23/2025
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Provider Practice Location Address
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Address Line | 13106 SE 240TH ST STE 202
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City | KENT
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State | WA
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Zip | 98031-9211
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Country | US
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Telephone | 253-630-1332
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Fax | 253-639-4809
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Provider Business Mailing Address
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Address Line | 13106 SE 240TH ST STE 202
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City | KENT
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State | WA
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Zip | 98031-9211
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Country | US
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Telephone | 425-269-6575
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Fax | 253-639-4809
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Authorized Official
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Title or Position | OWNER
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Name | LISA D CRATER-COEN
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Credential | LMT, RN
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Telephone | 253-630-1332
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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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