MEDICARE: SEATTLE ASIAN MEDICINE AND MARTIAL ARTS 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	MA00023022	WA

General Provider Information

NPI Number	:	1518365261
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	SEATTLE ASIAN MEDICINE AND MARTIAL ARTS PLLC

Provider Business Mailing Address
First Line	:	12025 LAKE CITY WAY NE
Second Line	:	SUITE B
City	:	SEATTLE
State	:	WA
Zip	:	98125-5331
Country	:	US
Telephone Number	:	206-363-0471
Fax Number	:

Provider Business Practice Location Address
First Line	:	12025 LAKE CITY WAY NE
Second Line	:	SUITE B
City	:	SEATTLE
State	:	WA
Zip	:	98125-5331
Country	:	US
Telephone Number	:	206-363-0471
Fax Number	:

Authorized Official
Title or Position	:	SPA MANAGER
Name	:	MRS. MARY WANDA CASHMAN
Credential	:
Telephone Number	:	206-363-0471

Provider Enumeration Date	:	12/11/2014
Last Update Date	:	12/11/2014

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