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General NPI Number Information
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NPI Number | 1700657830
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Entity Type | Organization
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Legal Business Name | ESSENTIAL MASSAGE WW LLC
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Dates
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Enumeration Date | 01/09/2024
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Last Update Date | 01/09/2024
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Provider Practice Location Address
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Address Line | 4208 LEARY WAY NW
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City | SEATTLE
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State | WA
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Zip | 98107-4535
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Country | US
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Telephone | 509-520-3402
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Fax | 833-463-1707
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Provider Business Mailing Address
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Address Line | 5210 RUSSELL AVE NW APT 112
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City | SEATTLE
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State | WA
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Zip | 98107-3937
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Country | US
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Telephone | 509-520-3402
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Fax | 833-463-1707
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Authorized Official
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Title or Position | OWNER
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Name | JANA LAMEE LESLEI
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Credential | LMT
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Telephone | 509-520-3402
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QH0100X
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Taxonomy Name | Health Service Clinic/Center
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License Number |
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License Number State |
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