Provider Demographics
NPI:1437555273
Name:MASSAGE CONNECTION, PLLC
Entity Type:Organization
Organization Name:MASSAGE CONNECTION, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER,MASSAGE THERAPIST
Authorized Official - Prefix:
Authorized Official - First Name:KEELY
Authorized Official - Middle Name:N
Authorized Official - Last Name:STEWART
Authorized Official - Suffix:
Authorized Official - Credentials:LMP
Authorized Official - Phone:206-356-7932
Mailing Address - Street 1:16521 13TH AVE W
Mailing Address - Street 2:
Mailing Address - City:LYNNWOOD
Mailing Address - State:WA
Mailing Address - Zip Code:98037-8528
Mailing Address - Country:US
Mailing Address - Phone:206-356-7932
Mailing Address - Fax:425-408-1062
Practice Address - Street 1:16521 13TH AVE W
Practice Address - Street 2:
Practice Address - City:LYNNWOOD
Practice Address - State:WA
Practice Address - Zip Code:98037-8528
Practice Address - Country:US
Practice Address - Phone:206-356-7932
Practice Address - Fax:425-408-1062
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-11-06
Last Update Date:2014-11-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMA00017772174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty