MEDICARE: MISS XENIA MARIJA VINCENT LMT

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	MASS.MA.70065079	WA

General Provider Information

NPI Number	:	1528925369
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MISS XENIA MARIJA VINCENT LMT

Provider Business Mailing Address
First Line	:	101 E HASTINGS RD
Second Line	:
City	:	SPOKANE
State	:	WA
Zip	:	99218-4901
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	101 E HASTINGS RD
Second Line	:
City	:	SPOKANE
State	:	WA
Zip	:	99218-4901
Country	:	US
Telephone Number	:	509-340-3303
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	01/05/2026
Last Update Date	:	01/05/2026

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