Provider Demographics
NPI:1235517236
Name:LORA'S MASSAGE & AROMATHERAPY SERVICES
Entity Type:Organization
Organization Name:LORA'S MASSAGE & AROMATHERAPY SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:LICENCED MASSAGE PRACTITIONER/ SPA
Authorized Official - Prefix:MS
Authorized Official - First Name:LORA
Authorized Official - Middle Name:DENEEN
Authorized Official - Last Name:SMITH
Authorized Official - Suffix:
Authorized Official - Credentials:MA 60247742
Authorized Official - Phone:253-330-1583
Mailing Address - Street 1:12211 EDGEWOOD AVE SW
Mailing Address - Street 2:APT.# 12
Mailing Address - City:LAKEWOOD
Mailing Address - State:WA
Mailing Address - Zip Code:98498-1201
Mailing Address - Country:US
Mailing Address - Phone:253-330-1583
Mailing Address - Fax:
Practice Address - Street 1:12211 EDGEWOOD AVE SW
Practice Address - Street 2:APT.# 12
Practice Address - City:LAKEWOOD
Practice Address - State:WA
Practice Address - Zip Code:98498-1201
Practice Address - Country:US
Practice Address - Phone:253-330-1583
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-05-11
Last Update Date:2015-05-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMA60247742286500000X, 305S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes286500000XHospitalsMilitary Hospital
No305S00000XManaged Care OrganizationsPoint of Service