Provider Demographics
NPI:1235919101
Name:MARIE DUFRESNE
Entity Type:Organization
Organization Name:MARIE DUFRESNE
Other - Org Name:MAHAL BODYWORK STUDIO
Other - Org Type:Doing Business As
Authorized Official - Title/Position:LMT
Authorized Official - Prefix:
Authorized Official - First Name:MARIE
Authorized Official - Middle Name:
Authorized Official - Last Name:DUFRESNE
Authorized Official - Suffix:
Authorized Official - Credentials:MA, CHT, LMT
Authorized Official - Phone:415-465-2401
Mailing Address - Street 1:2307 HENRY ST
Mailing Address - Street 2:
Mailing Address - City:BELLINGHAM
Mailing Address - State:WA
Mailing Address - Zip Code:98225-2208
Mailing Address - Country:US
Mailing Address - Phone:415-465-2401
Mailing Address - Fax:206-826-6399
Practice Address - Street 1:1200 HARRIS AVE STE 405
Practice Address - Street 2:
Practice Address - City:BELLINGHAM
Practice Address - State:WA
Practice Address - Zip Code:98225-7146
Practice Address - Country:US
Practice Address - Phone:415-465-2401
Practice Address - Fax:206-826-6399
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-09-29
Last Update Date:2024-01-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage TherapistGroup - Single Specialty