Provider Demographics
NPI:1780030023
Name:REJUV MASSAGE AND SPA
Entity Type:Organization
Organization Name:REJUV MASSAGE AND SPA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/LMP
Authorized Official - Prefix:
Authorized Official - First Name:JULIE
Authorized Official - Middle Name:
Authorized Official - Last Name:POSTON
Authorized Official - Suffix:
Authorized Official - Credentials:LMP
Authorized Official - Phone:360-405-0293
Mailing Address - Street 1:1007 SCOTT AVE
Mailing Address - Street 2:STE B
Mailing Address - City:BREMERTON
Mailing Address - State:WA
Mailing Address - Zip Code:98310-4874
Mailing Address - Country:US
Mailing Address - Phone:360-405-0293
Mailing Address - Fax:
Practice Address - Street 1:1007 SCOTT AVE
Practice Address - Street 2:STE B
Practice Address - City:BREMERTON
Practice Address - State:WA
Practice Address - Zip Code:98310-4874
Practice Address - Country:US
Practice Address - Phone:360-405-0293
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-05-05
Last Update Date:2016-05-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMA60617357225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage TherapistGroup - Single Specialty