Provider Demographics
NPI:1093182974
Name:THOMAS MANSON LMP
Entity Type:Organization
Organization Name:THOMAS MANSON LMP
Other - Org Name:RESTORATIVE MASSAGE SERVICES
Other - Org Type:Doing Business As
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:FELISHA
Authorized Official - Middle Name:
Authorized Official - Last Name:PEDERSON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:509-570-5155
Mailing Address - Street 1:3120 S GRAND BLVD UNIT 8473
Mailing Address - Street 2:
Mailing Address - City:SPOKANE
Mailing Address - State:WA
Mailing Address - Zip Code:99203-2681
Mailing Address - Country:US
Mailing Address - Phone:509-951-7347
Mailing Address - Fax:509-847-1117
Practice Address - Street 1:308 W 1ST AVE STE 209
Practice Address - Street 2:
Practice Address - City:SPOKANE
Practice Address - State:WA
Practice Address - Zip Code:99201-6002
Practice Address - Country:US
Practice Address - Phone:509-951-7347
Practice Address - Fax:509-847-1117
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-08-27
Last Update Date:2015-08-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMA00006309225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage TherapistGroup - Single Specialty