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General NPI Number Information
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NPI Number | 1902176589
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Entity Type | Organization
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Legal Business Name | NATURAL BODY WORKS
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Dates
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Enumeration Date | 01/12/2012
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Last Update Date | 01/12/2012
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Provider Practice Location Address
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Address Line | 106 E 9TH ST
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City | VANCOUVER
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State | WA
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Zip | 98660-3269
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Country | US
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Telephone | 360-513-7531
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Fax | 360-694-9726
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Provider Business Mailing Address
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Address Line | 106 E 9TH ST
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City | VANCOUVER
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State | WA
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Zip | 98660-3269
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Country | US
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Telephone | 360-513-7531
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Fax | 360-694-9726
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Authorized Official
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Title or Position | MASSAGE THERAPIST, OWNER, OPERATOR
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Name | SHANNA M ARNO
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Credential | LMP
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Telephone | 360-513-7531
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 174400000X
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Taxonomy Name | Specialist
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License Number | MA00021648
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License Number State | WA
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