Provider Demographics
NPI:1114639853
Name:SEATTLE MASSAGE PRO LLC
Entity Type:Organization
Organization Name:SEATTLE MASSAGE PRO LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:AMBER
Authorized Official - Middle Name:
Authorized Official - Last Name:MYERS
Authorized Official - Suffix:
Authorized Official - Credentials:LMT
Authorized Official - Phone:206-909-2994
Mailing Address - Street 1:2514 E PINE ST
Mailing Address - Street 2:
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98122-3044
Mailing Address - Country:US
Mailing Address - Phone:206-909-2994
Mailing Address - Fax:206-922-2053
Practice Address - Street 1:2818 E MADISON ST
Practice Address - Street 2:
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98112-4841
Practice Address - Country:US
Practice Address - Phone:206-397-3590
Practice Address - Fax:206-922-2053
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-12-14
Last Update Date:2022-12-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage TherapistGroup - Single Specialty