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General NPI Number Information
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NPI Number | 1659039865
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Entity Type | Individual
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Provider Name | PASHAN SUEING MASSAGE THERAPIST
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Gender | Female
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Dates
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Enumeration Date | 12/05/2021
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Last Update Date | 06/26/2023
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Provider Practice Location Address
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Address Line | 1130 E MISSOURI AVE STE 720
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City | PHOENIX
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State | AZ
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Zip | 85014-4382
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Country | US
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Telephone | 615-625-5873
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Fax |
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Provider Business Mailing Address
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Address Line | 3317 E BELL RD STE 101 PMB #262
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City | PHOENIX
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State | AZ
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Zip | 85032-2726
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Country | US
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Telephone | 480-848-4704
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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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 | MT-28076
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License Number State | AZ
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