Provider Demographics
NPI:1689118002
Name:MAGIC TOUCH MASSAGE, LLC
Entity Type:Organization
Organization Name:MAGIC TOUCH MASSAGE, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MS
Authorized Official - First Name:CINDY
Authorized Official - Middle Name:LEE
Authorized Official - Last Name:SCHIPPER
Authorized Official - Suffix:
Authorized Official - Credentials:LMP
Authorized Official - Phone:253-861-4432
Mailing Address - Street 1:PO BOX 45195
Mailing Address - Street 2:
Mailing Address - City:TACOMA
Mailing Address - State:WA
Mailing Address - Zip Code:98448-5195
Mailing Address - Country:US
Mailing Address - Phone:253-531-5917
Mailing Address - Fax:253-531-5917
Practice Address - Street 1:504 GARFIELD ST S
Practice Address - Street 2:
Practice Address - City:TACOMA
Practice Address - State:WA
Practice Address - Zip Code:98444-3628
Practice Address - Country:US
Practice Address - Phone:253-531-5917
Practice Address - Fax:253-531-5917
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-12-05
Last Update Date:2016-12-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMA00023343174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA1356898530OtherLMP
WA1104001783OtherLMP
WA1306135306OtherLMP