Provider Demographics
NPI:1558531590
Name:ON-SITE MASSAGE, INC.
Entity Type:Organization
Organization Name:ON-SITE MASSAGE, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MASSAGE THERAPIST
Authorized Official - Prefix:
Authorized Official - First Name:ANGELA
Authorized Official - Middle Name:FRANCES
Authorized Official - Last Name:CUMMINS
Authorized Official - Suffix:
Authorized Official - Credentials:LMP
Authorized Official - Phone:425-355-3561
Mailing Address - Street 1:PO BOX 292
Mailing Address - Street 2:
Mailing Address - City:MUKILTEO
Mailing Address - State:WA
Mailing Address - Zip Code:98275-0292
Mailing Address - Country:US
Mailing Address - Phone:425-355-3561
Mailing Address - Fax:
Practice Address - Street 1:626 128TH ST SW
Practice Address - Street 2:SUITE 103 B
Practice Address - City:EVERETT
Practice Address - State:WA
Practice Address - Zip Code:98204-6368
Practice Address - Country:US
Practice Address - Phone:425-513-1880
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-03-05
Last Update Date:2008-03-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMA3520174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty