Provider Demographics
NPI:1437689908
Name:CORINA MORSER LICENSE MASSAGE PRACTITIONER PLLC
Entity Type:Organization
Organization Name:CORINA MORSER LICENSE MASSAGE PRACTITIONER PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/ LICENSE MASSAGE PRACTITIONER
Authorized Official - Prefix:
Authorized Official - First Name:CORINA
Authorized Official - Middle Name:MARIE
Authorized Official - Last Name:MORSER-GRAHAM
Authorized Official - Suffix:
Authorized Official - Credentials:LMP
Authorized Official - Phone:425-443-5656
Mailing Address - Street 1:465 SW FOREST PL
Mailing Address - Street 2:
Mailing Address - City:ISSAQUAH
Mailing Address - State:WA
Mailing Address - Zip Code:98027-4606
Mailing Address - Country:US
Mailing Address - Phone:425-443-5656
Mailing Address - Fax:
Practice Address - Street 1:465 SW FOREST PL
Practice Address - Street 2:
Practice Address - City:ISSAQUAH
Practice Address - State:WA
Practice Address - Zip Code:98027-4606
Practice Address - Country:US
Practice Address - Phone:425-443-5656
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-06-15
Last Update Date:2018-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage TherapistGroup - Multi-Specialty
No174400000XOther Service ProvidersSpecialistGroup - Multi-Specialty