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General NPI Number Information
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NPI Number | 1982553905
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Entity Type | Organization
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Legal Business Name | DOUBLE DIAMOND MASSAGE
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Dates
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Enumeration Date | 01/23/2026
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Last Update Date | 01/23/2026
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Provider Practice Location Address
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Address Line | 14207 MERIDIAN E STE 100
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City | PUYALLUP
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State | WA
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Zip | 98373-2414
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Country | US
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Telephone | 253-365-4331
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Fax |
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Provider Business Mailing Address
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Address Line | 19317 105TH AVENUE CT E
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City | GRAHAM
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State | WA
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Zip | 98338-6450
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Country | US
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Telephone | 253-365-3710
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | KARI MINNIEMAE AUSTIN
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Credential | LMT
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Telephone | 360-582-7271
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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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