Provider Demographics
NPI:1679930739
Name:SATORI MASSAGE
Entity Type:Organization
Organization Name:SATORI MASSAGE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MASSAGE PRACTITIONER/OWNER
Authorized Official - Prefix:MS
Authorized Official - First Name:SATORI
Authorized Official - Middle Name:B
Authorized Official - Last Name:HANSON
Authorized Official - Suffix:
Authorized Official - Credentials:LMP
Authorized Official - Phone:3609-200-3554
Mailing Address - Street 1:1920 MAIN ST
Mailing Address - Street 2:SUITE 14 D
Mailing Address - City:FERNDALE
Mailing Address - State:WA
Mailing Address - Zip Code:98248-9472
Mailing Address - Country:US
Mailing Address - Phone:360-920-0354
Mailing Address - Fax:
Practice Address - Street 1:1920 MAIN ST
Practice Address - Street 2:SUITE 14 D
Practice Address - City:FERNDALE
Practice Address - State:WA
Practice Address - Zip Code:98248-9472
Practice Address - Country:US
Practice Address - Phone:360-920-0354
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-01-20
Last Update Date:2016-01-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMA60496637225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage TherapistGroup - Single Specialty