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General NPI Number Information
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NPI Number | 1992826549
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Entity Type | Organization
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Legal Business Name | HEALING TOUCH MASSAGE
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Dates
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Enumeration Date | 04/02/2007
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Last Update Date | 07/02/2008
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Provider Practice Location Address
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Address Line | 110 S BROADWAY AVE
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City | OTHELLO
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State | WA
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Zip | 99344-1346
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Country | US
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Telephone | 509-989-0875
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Fax | 509-488-7224
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Provider Business Mailing Address
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Address Line | 110 S BROADWAY AVE
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City | OTHELLO
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State | WA
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Zip | 99344-1346
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Country | US
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Telephone | 509-989-0875
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Fax | 509-488-7224
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Authorized Official
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Title or Position | MASSAGE THERAPIST
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Name | MRS. DEBORAH M. RUSSELL
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Credential | LMP
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Telephone | 509-989-0875
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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 | MA00015323
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License Number State | WA
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