Provider Demographics
NPI:1790148781
Name:MELISSA M WARD
Entity Type:Organization
Organization Name:MELISSA M WARD
Other - Org Name:HEALING MOMENTUM MASSAGE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:LICENSED MASSAGE PRACTITIONER
Authorized Official - Prefix:
Authorized Official - First Name:MELISSA
Authorized Official - Middle Name:MARIE
Authorized Official - Last Name:WARD
Authorized Official - Suffix:
Authorized Official - Credentials:LMP
Authorized Official - Phone:509-599-1196
Mailing Address - Street 1:5107 N ELM ST
Mailing Address - Street 2:
Mailing Address - City:SPOKANE
Mailing Address - State:WA
Mailing Address - Zip Code:99205-5544
Mailing Address - Country:US
Mailing Address - Phone:509-599-1196
Mailing Address - Fax:
Practice Address - Street 1:634 W GARLAND AVE
Practice Address - Street 2:
Practice Address - City:SPOKANE
Practice Address - State:WA
Practice Address - Zip Code:99205-2955
Practice Address - Country:US
Practice Address - Phone:509-599-1196
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-03-29
Last Update Date:2016-03-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA60320908225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage TherapistGroup - Single Specialty