Provider Demographics
NPI:1558993725
Name:MEGAN'S MASSAGE AND ESTHETICS LLC
Entity Type:Organization
Organization Name:MEGAN'S MASSAGE AND ESTHETICS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/PRACTITIONER/MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:MEGAN
Authorized Official - Middle Name:JO-LYNN
Authorized Official - Last Name:PAULSON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:253-350-3833
Mailing Address - Street 1:709 GRIFFIN AVE
Mailing Address - Street 2:
Mailing Address - City:ENUMCLAW
Mailing Address - State:WA
Mailing Address - Zip Code:98022
Mailing Address - Country:US
Mailing Address - Phone:253-350-3833
Mailing Address - Fax:253-350-3833
Practice Address - Street 1:709 GRIFFIN AVE
Practice Address - Street 2:
Practice Address - City:ENUMCLAW
Practice Address - State:WA
Practice Address - Zip Code:98022
Practice Address - Country:US
Practice Address - Phone:253-350-3833
Practice Address - Fax:253-350-3833
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-02-06
Last Update Date:2020-02-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage TherapistGroup - Single Specialty