MEDICARE: DANIEL SANSONE MASSAGE 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

General Provider Information

NPI Number	:	1952058406
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	DANIEL SANSONE MASSAGE PLLC

Provider Business Mailing Address
First Line	:	2520 E MARION ST
Second Line	:
City	:	SEATTLE
State	:	WA
Zip	:	98122-4943
Country	:	US
Telephone Number	:	317-607-4590
Fax Number	:

Provider Business Practice Location Address
First Line	:	1812 E MADISON ST STE 40
Second Line	:
City	:	SEATTLE
State	:	WA
Zip	:	98122-2818
Country	:	US
Telephone Number	:	317-607-4590
Fax Number	:

Authorized Official
Title or Position	:	OWNER/PROVIDER
Name	:	DANIEL LEE SANSONE
Credential	:	LMT
Telephone Number	:	317-607-4590

Provider Enumeration Date	:	03/04/2022
Last Update Date	:	03/04/2022

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