Provider Demographics
NPI:1003935875
Name:VALLEY MASSGE CLINIC
Entity Type:Organization
Organization Name:VALLEY MASSGE CLINIC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:RACHEL
Authorized Official - Middle Name:M
Authorized Official - Last Name:KILAYKO
Authorized Official - Suffix:
Authorized Official - Credentials:LMT
Authorized Official - Phone:509-921-9800
Mailing Address - Street 1:12121 E BROADWAY AVE STE 5B
Mailing Address - Street 2:
Mailing Address - City:SPOKANE VALLEY
Mailing Address - State:WA
Mailing Address - Zip Code:99206-4972
Mailing Address - Country:US
Mailing Address - Phone:509-921-9800
Mailing Address - Fax:
Practice Address - Street 1:12121 E BROADWAY AVE STE 5B
Practice Address - Street 2:
Practice Address - City:SPOKANE VALLEY
Practice Address - State:WA
Practice Address - Zip Code:99206-4972
Practice Address - Country:US
Practice Address - Phone:509-921-9800
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-29
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty