MEDICARE: URBAN HEALING ARTS STUDIO, 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
1	225700000X	Massage Therapist	MA00021474	WA

General Provider Information

NPI Number	:	1467722108
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	URBAN HEALING ARTS STUDIO, LLC

Provider Business Mailing Address
First Line	:	8113 STONE AVE N
Second Line	:
City	:	SEATTLE
State	:	WA
Zip	:	98103-4414
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	8119 STONE AVE N
Second Line	:
City	:	SEATTLE
State	:	WA
Zip	:	98103-4414
Country	:	US
Telephone Number	:	888-718-7226
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	MRS. JULIE JENKINS
Credential	:
Telephone Number	:	206-226-5533

Provider Enumeration Date	:	01/11/2012
Last Update Date	:	01/11/2012

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