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General NPI Number Information
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NPI Number | 1902280951
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Entity Type | Organization
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Legal Business Name | COHESIVE MASSAGE THERAPY, LLC
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Dates
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Enumeration Date | 07/18/2015
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Last Update Date | 07/18/2015
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Provider Practice Location Address
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Address Line | 2400 BROADWAY ST
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City | VANCOUVER
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State | WA
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Zip | 98663-3229
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Country | US
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Telephone | 541-288-3293
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Fax |
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Provider Business Mailing Address
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Address Line | 2400 BROADWAY ST
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City | VANCOUVER
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State | WA
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Zip | 98663-3229
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Country | US
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Telephone | 541-288-3293
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | GEPPINA SCRIGNA
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Credential | LMP
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Telephone | 541-288-3293
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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 | MA60325881
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License Number State | WA
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