Provider Demographics
NPI:1558886440
Name:BODY COMPASS MASSAGE LLC
Entity Type:Organization
Organization Name:BODY COMPASS MASSAGE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:STEPHANIE
Authorized Official - Middle Name:BARROW
Authorized Official - Last Name:BROOK
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:509-430-3214
Mailing Address - Street 1:5232 OUTLET DR
Mailing Address - Street 2:
Mailing Address - City:PASCO
Mailing Address - State:WA
Mailing Address - Zip Code:99301-8969
Mailing Address - Country:US
Mailing Address - Phone:509-430-3214
Mailing Address - Fax:
Practice Address - Street 1:5232 OUTLET DR
Practice Address - Street 2:
Practice Address - City:PASCO
Practice Address - State:WA
Practice Address - Zip Code:99301-8969
Practice Address - Country:US
Practice Address - Phone:509-430-3214
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-08-11
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMA000195547225700000X
WAMA00019547225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage TherapistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA=========OtherMASSAGE THERAPIST