MEDICARE: SOUTHSOUND TREATMENT MASSAGE

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	60179153	WA

General Provider Information

NPI Number	:	1487993325
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	SOUTHSOUND TREATMENT MASSAGE

Provider Business Mailing Address
First Line	:	818 39TH AVE SW STE A
Second Line	:
City	:	PUYALLUP
State	:	WA
Zip	:	98373-3308
Country	:	US
Telephone Number	:	253-841-2200
Fax Number	:	253-848-1075

Provider Business Practice Location Address
First Line	:	818 39TH AVE SW STE A
Second Line	:
City	:	PUYALLUP
State	:	WA
Zip	:	98373-3308
Country	:	US
Telephone Number	:	253-841-2200
Fax Number	:	253-848-1075

Authorized Official
Title or Position	:	OWNER
Name	:	MELISSA N BROWN
Credential	:	LMP
Telephone Number	:	253-841-2200

Provider Enumeration Date	:	02/13/2013
Last Update Date	:	02/13/2013

Similar Medicare Providers

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Practice Location Address:

818 39TH AVE SW , SUITE A
PUYALLUP, WA
98373-3308

Practice Phone: 253-841-2200
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1194057604 — RUTH KEHELEY BURNETT LMP
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818 39TH AVE SW STE A
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1770882342 — MEGAN SCHIFFNER LMP
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818 39TH AVE SW , SUITE A
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98373-3308

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1659786200 — ASHLEY KINGSTON LMP
Practice Location Address:

818 39TH AVE SW , SUITE A
PUYALLUP, WA
98373-3308

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Practice Fax:

1912422023 — KERRI EILEEN CADY
Practice Location Address:

818 39TH AVE SW STE B
PUYALLUP, WA
98373-3308

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1770132417 — KATHERINE LURBIECKI
Practice Location Address:

818 39TH AVE SW STE B
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98373-3308

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