Provider Demographics
NPI:1235274374
Name:MARQUIS MASSAGE GROUP, LLC
Entity Type:Organization
Organization Name:MARQUIS MASSAGE GROUP, LLC
Other - Org Name:BODY WORKS MASSAGE CLINIC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:ADRIEN
Authorized Official - Middle Name:
Authorized Official - Last Name:ZEUMAULT
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:425-392-1814
Mailing Address - Street 1:12932 SE KENT KANGLEY RD
Mailing Address - Street 2:SUITE 438
Mailing Address - City:KENT
Mailing Address - State:WA
Mailing Address - Zip Code:98030-7940
Mailing Address - Country:US
Mailing Address - Phone:425-392-1814
Mailing Address - Fax:425-392-1813
Practice Address - Street 1:27116 167TH PL SE
Practice Address - Street 2:SUITE 114
Practice Address - City:COVINGTON
Practice Address - State:WA
Practice Address - Zip Code:98042-7341
Practice Address - Country:US
Practice Address - Phone:253-630-6614
Practice Address - Fax:253-630-6624
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-20
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage TherapistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA0182246OtherDEPT OF L&I