Provider Demographics
NPI:1073911673
Name:PROFESSIONAL HANDS OF HEALTH MASSAGE
Entity Type:Organization
Organization Name:PROFESSIONAL HANDS OF HEALTH MASSAGE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/LMP
Authorized Official - Prefix:MS
Authorized Official - First Name:DONI
Authorized Official - Middle Name:K
Authorized Official - Last Name:SHULTZ
Authorized Official - Suffix:
Authorized Official - Credentials:MA60399965
Authorized Official - Phone:509-679-1029
Mailing Address - Street 1:1429 EASTHILLS TER
Mailing Address - Street 2:
Mailing Address - City:EAST WENATCHEE
Mailing Address - State:WA
Mailing Address - Zip Code:98802-4624
Mailing Address - Country:US
Mailing Address - Phone:509-679-1029
Mailing Address - Fax:
Practice Address - Street 1:1429 EASTHILLS TER
Practice Address - Street 2:
Practice Address - City:EAST WENATCHEE
Practice Address - State:WA
Practice Address - Zip Code:98802-4624
Practice Address - Country:US
Practice Address - Phone:509-679-1029
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-12-12
Last Update Date:2014-12-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMA6039965302R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes302R00000XManaged Care OrganizationsHealth Maintenance Organization