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General NPI Number Information
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NPI Number | 1740844430
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Entity Type | Organization
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Legal Business Name | SUBLIME THERAPEUTIC MASSAGE, INC.
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Dates
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Enumeration Date | 04/28/2019
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Last Update Date | 04/28/2019
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Provider Practice Location Address
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Address Line | 1020 E 34TH ST
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City | TACOMA
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State | WA
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Zip | 98404-3105
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Country | US
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Telephone | 253-882-9752
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Fax | 253-231-7949
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Provider Business Mailing Address
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Address Line | 1020 E 34TH ST
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City | TACOMA
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State | WA
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Zip | 98404-3105
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Country | US
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Telephone | 253-882-9752
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Fax | 253-231-7949
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Authorized Official
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Title or Position | PRESIDENT
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Name | DARCY WEBBER
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Credential | LMT
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Telephone | 253-882-9752
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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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