Provider Demographics
NPI:1598061095
Name:STILLPOINT THERAPEUTIC MASSAGE PLLC
Entity Type:Organization
Organization Name:STILLPOINT THERAPEUTIC MASSAGE PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:REGISTERED AGENT
Authorized Official - Prefix:MS
Authorized Official - First Name:KATHERINE
Authorized Official - Middle Name:LOUISE
Authorized Official - Last Name:CROW
Authorized Official - Suffix:
Authorized Official - Credentials:LMP
Authorized Official - Phone:509-953-7392
Mailing Address - Street 1:819 S IVORY ST
Mailing Address - Street 2:
Mailing Address - City:SPOKANE
Mailing Address - State:WA
Mailing Address - Zip Code:99202-2450
Mailing Address - Country:US
Mailing Address - Phone:509-953-7392
Mailing Address - Fax:
Practice Address - Street 1:2607 S SOUTHEAST BLVD
Practice Address - Street 2:B-111
Practice Address - City:SPOKANE
Practice Address - State:WA
Practice Address - Zip Code:99223-4942
Practice Address - Country:US
Practice Address - Phone:509-953-7392
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-01-31
Last Update Date:2011-01-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMA 60045863172M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes172M00000XOther Service ProvidersMechanotherapistGroup - Single Specialty