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NPI Code Detail

MEDICARE: SEATTLE MASSAGE PRO LLC

MEDICARE: SEATTLE MASSAGE PRO LLC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1225700000XMassage Therapist

General Provider Information

NPI Number : 1114639853
Entity Type Code : Organization
Provider Name (Legal Business Name) : SEATTLE MASSAGE PRO LLC
Provider Business Mailing Address
First Line : 2514 E PINE ST
Second Line :
City : SEATTLE
State : WA
Zip : 98122-3044
Country : US
Telephone Number : 206-909-2994
Fax Number : 206-922-2053
Provider Business Practice Location Address
First Line : 2818 E MADISON ST
Second Line :
City : SEATTLE
State : WA
Zip : 98112-4841
Country : US
Telephone Number : 206-397-3590
Fax Number : 206-922-2053
Authorized Official
Title or Position : CEO
Name : AMBER MYERS
Credential : LMT
Telephone Number : 206-909-2994
Provider Enumeration Date : 12/14/2022
Last Update Date : 12/14/2022

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Directions to “SEATTLE MASSAGE PRO LLC ” Practice Location

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