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General NPI Number Information
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NPI Number | 1861228926
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Entity Type | Organization
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Legal Business Name | SALT & SEA SPA
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Dates
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Enumeration Date | 09/13/2024
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Last Update Date | 09/13/2024
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Provider Practice Location Address
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Address Line | 298 S MAIN ST STE K
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City | COLVILLE
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State | WA
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Zip | 99114-2400
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Country | US
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Telephone | 509-944-5555
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Fax |
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Provider Business Mailing Address
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Address Line | 298 S MAIN ST STE K
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City | COLVILLE
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State | WA
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Zip | 99114-2400
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Country | US
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Telephone | 509-944-5555
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Fax |
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Authorized Official
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Title or Position | LMT
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Name | MISS SALAMIA MIKHEYEVA
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Credential | LMT
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Telephone | 509-944-5555
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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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