Provider Demographics
NPI:1073958203
Name:EXHALE THERAPEUTIC MASSAGE
Entity Type:Organization
Organization Name:EXHALE THERAPEUTIC MASSAGE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SOLE PROPRIETOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:KYMBERLI
Authorized Official - Middle Name:ANN
Authorized Official - Last Name:FELGEN
Authorized Official - Suffix:
Authorized Official - Credentials:LMP
Authorized Official - Phone:360-723-5475
Mailing Address - Street 1:105 MAIN ST.
Mailing Address - Street 2:207
Mailing Address - City:BATTLE GROUND
Mailing Address - State:WA
Mailing Address - Zip Code:98604-4861
Mailing Address - Country:US
Mailing Address - Phone:360-991-6732
Mailing Address - Fax:
Practice Address - Street 1:1216 SE 6TH ST
Practice Address - Street 2:
Practice Address - City:BATTLE GROUND
Practice Address - State:WA
Practice Address - Zip Code:98604-4861
Practice Address - Country:US
Practice Address - Phone:360-723-5475
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-05-01
Last Update Date:2013-05-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA00024553225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage TherapistGroup - Single Specialty