MEDICARE: ROCK SOLID MASSAGE & BODYWORK, PLLC

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
1	225700000X	Massage Therapist	MA60402201	WA

General Provider Information

NPI Number	:	1154797397
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ROCK SOLID MASSAGE & BODYWORK, PLLC

Provider Business Mailing Address
First Line	:	6000 17TH AVE SW APT 21
Second Line	:
City	:	SEATTLE
State	:	WA
Zip	:	98106-3525
Country	:	US
Telephone Number	:	206-353-2012
Fax Number	:

Provider Business Practice Location Address
First Line	:	3272 CALIFORNIA AVE SW
Second Line	:	SUITE 103
City	:	SEATTLE
State	:	WA
Zip	:	98116-3375
Country	:	US
Telephone Number	:	206-353-2012
Fax Number	:

Authorized Official
Title or Position	:	OWNER OPERATOR
Name	:	DARIN STUMME
Credential	:	LMP
Telephone Number	:	206-353-2012

Provider Enumeration Date	:	08/11/2015
Last Update Date	:	08/11/2015

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