Provider Demographics
NPI:1346576576
Name:HEALTHFUL SOLUTIONS MASSAGE
Entity Type:Organization
Organization Name:HEALTHFUL SOLUTIONS MASSAGE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MS
Authorized Official - First Name:JACKIE
Authorized Official - Middle Name:IDA
Authorized Official - Last Name:FORGEY
Authorized Official - Suffix:
Authorized Official - Credentials:LMP
Authorized Official - Phone:253-661-8685
Mailing Address - Street 1:200 SOUTH 333RD STREET
Mailing Address - Street 2:SUITE 140
Mailing Address - City:FEDERAL WAY
Mailing Address - State:WA
Mailing Address - Zip Code:98003
Mailing Address - Country:US
Mailing Address - Phone:253-661-8768
Mailing Address - Fax:
Practice Address - Street 1:200 S 333RD ST
Practice Address - Street 2:SUITE 140
Practice Address - City:FEDERAL WAY
Practice Address - State:WA
Practice Address - Zip Code:98003-7359
Practice Address - Country:US
Practice Address - Phone:253-661-8768
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-10-22
Last Update Date:2009-10-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMA00007029225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage TherapistGroup - Single Specialty