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General NPI Number Information
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NPI Number | 1649785932
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Entity Type | Organization
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Legal Business Name | FORWARD MASSAGE AND WELLNESS LLC
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Dates
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Enumeration Date | 12/07/2017
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Last Update Date | 07/21/2022
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Provider Practice Location Address
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Address Line | 14217 EVANSTON AVE N
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City | SEATTLE
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State | WA
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Zip | 98133-6856
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Country | US
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Telephone | 206-226-8622
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Fax |
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Provider Business Mailing Address
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Address Line | 14217 EVANSTON AVE N
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City | SEATTLE
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State | WA
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Zip | 98133-6856
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Country | US
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Telephone | 206-226-8622
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | MICHAEL JOSEPH RITTER
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Credential | LMT
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Telephone | 206-775-3649
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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 | MA60776905
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License Number State | WA
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