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General NPI Number Information
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NPI Number | 1871967430
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Entity Type | Organization
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Legal Business Name | UPRIGHT TREATMENT & MASSAGE
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Dates
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Enumeration Date | 11/19/2015
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Last Update Date | 11/19/2015
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Provider Practice Location Address
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Address Line | 16720 116TH AVE SE SUITE 2
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City | RENTON
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State | WA
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Zip | 98058-5277
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Country | US
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Telephone | 206-317-9652
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Fax |
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Provider Business Mailing Address
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Address Line | 16720 116TH AVE SE SUITE 2
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City | RENTON
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State | WA
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Zip | 98058-5277
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Country | US
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Telephone | 206-317-9652
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Fax |
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Authorized Official
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Title or Position | OWNER/MASSAGE THERAPIST
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Name | MR. RICHARD FERGUSON
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Credential | LMP
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Telephone | 206-317-9652
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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 | 60353060411
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License Number State | WA
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