Provider Demographics
NPI:1093141848
Name:ANEW YOU MASSAGE THERAPY PLLC
Entity Type:Organization
Organization Name:ANEW YOU MASSAGE THERAPY PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MS
Authorized Official - First Name:WENA
Authorized Official - Middle Name:LYNN
Authorized Official - Last Name:DOVE
Authorized Official - Suffix:
Authorized Official - Credentials:LMP
Authorized Official - Phone:509-469-9703
Mailing Address - Street 1:319 S 11TH AVE
Mailing Address - Street 2:
Mailing Address - City:YAKIMA
Mailing Address - State:WA
Mailing Address - Zip Code:98902-3213
Mailing Address - Country:US
Mailing Address - Phone:509-406-5763
Mailing Address - Fax:
Practice Address - Street 1:319 S 11TH AVE
Practice Address - Street 2:
Practice Address - City:YAKIMA
Practice Address - State:WA
Practice Address - Zip Code:98902-3213
Practice Address - Country:US
Practice Address - Phone:509-406-5763
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-09-24
Last Update Date:2013-09-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage TherapistGroup - Single Specialty