Provider Demographics
NPI:1265841175
Name:VALENTINE YOGA THERAPY, LLC
Entity Type:Organization
Organization Name:VALENTINE YOGA THERAPY, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEMBER
Authorized Official - Prefix:MRS
Authorized Official - First Name:MAUDE
Authorized Official - Middle Name:EILEEN
Authorized Official - Last Name:VALENTINE
Authorized Official - Suffix:
Authorized Official - Credentials:RYT 500
Authorized Official - Phone:253-318-5273
Mailing Address - Street 1:420 S 35TH ST
Mailing Address - Street 2:
Mailing Address - City:TACOMA
Mailing Address - State:WA
Mailing Address - Zip Code:98418-6822
Mailing Address - Country:US
Mailing Address - Phone:253-318-5273
Mailing Address - Fax:
Practice Address - Street 1:420 S 35TH ST
Practice Address - Street 2:
Practice Address - City:TACOMA
Practice Address - State:WA
Practice Address - Zip Code:98418-6822
Practice Address - Country:US
Practice Address - Phone:253-318-5273
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-08-05
Last Update Date:2014-08-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA603320756174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty