=====================================================
General NPI Number Information
=====================================================
NPI Number | 1912829045
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | WHIDBEY PRODUCTIONS INC. DBA WHIDBEY MASSAGE THERAPY
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 07/29/2026
-----------------------------------------------------
Last Update Date | 07/29/2026
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 1705 MAIN ST
-----------------------------------------------------
City | FREELAND
-----------------------------------------------------
State | WA
-----------------------------------------------------
Zip | 98249-9423
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 360-217-9303
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 1705 MAIN ST
-----------------------------------------------------
City | FREELAND
-----------------------------------------------------
State | WA
-----------------------------------------------------
Zip | 98249-9423
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 360-217-9303
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | OWNER/LIC.MASSAGE THERAPIST
-----------------------------------------------------
Name | MARC JUNEAU
-----------------------------------------------------
Credential | LMT
-----------------------------------------------------
Telephone | 360-217-9303
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 225700000X
-----------------------------------------------------
Taxonomy Name | Massage Therapist
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------