Provider Demographics
NPI:1144591447
Name:ESSENTIAL MASSAGE
Entity Type:Organization
Organization Name:ESSENTIAL MASSAGE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:LMP/OWNER
Authorized Official - Prefix:
Authorized Official - First Name:CASSIE
Authorized Official - Middle Name:MICHELE
Authorized Official - Last Name:BAKER
Authorized Official - Suffix:
Authorized Official - Credentials:LMP
Authorized Official - Phone:509-474-1885
Mailing Address - Street 1:421 W RIVERSIDE AVE STE 614
Mailing Address - Street 2:
Mailing Address - City:SPOKANE
Mailing Address - State:WA
Mailing Address - Zip Code:99201-0402
Mailing Address - Country:US
Mailing Address - Phone:509-474-1885
Mailing Address - Fax:509-474-9756
Practice Address - Street 1:421 W RIVERSIDE AVE STE 614
Practice Address - Street 2:
Practice Address - City:SPOKANE
Practice Address - State:WA
Practice Address - Zip Code:99201-0402
Practice Address - Country:US
Practice Address - Phone:509-474-1885
Practice Address - Fax:509-474-9756
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-01-18
Last Update Date:2012-09-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMA00021616225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage TherapistGroup - Single Specialty