Provider Demographics
NPI:1083894398
Name:LOTUS WASHINGTON INC
Entity Type:Organization
Organization Name:LOTUS WASHINGTON INC
Other - Org Name:LA SERENITY SPA
Other - Org Type:Doing Business As
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:MR
Authorized Official - First Name:MUNETSUGU
Authorized Official - Middle Name:
Authorized Official - Last Name:YOKOBE
Authorized Official - Suffix:
Authorized Official - Credentials:MASSAGE THERAPIST
Authorized Official - Phone:425-990-0043
Mailing Address - Street 1:PO BOX 5521
Mailing Address - Street 2:
Mailing Address - City:BELLEVUE
Mailing Address - State:WA
Mailing Address - Zip Code:98006-0021
Mailing Address - Country:US
Mailing Address - Phone:425-990-0043
Mailing Address - Fax:
Practice Address - Street 1:10301 NE 10TH ST
Practice Address - Street 2:
Practice Address - City:BELLEVUE
Practice Address - State:WA
Practice Address - Zip Code:98004-4213
Practice Address - Country:US
Practice Address - Phone:425-990-0043
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-11-05
Last Update Date:2007-11-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMA00024401225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage TherapistGroup - Single Specialty