Provider Demographics
NPI:1821603291
Name:LAKE STEVENS MASSAGE THERAPY, INC.
Entity Type:Organization
Organization Name:LAKE STEVENS MASSAGE THERAPY, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MS
Authorized Official - First Name:JOYCE
Authorized Official - Middle Name:A
Authorized Official - Last Name:MARSH
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:425-238-3731
Mailing Address - Street 1:25 95TH DR NE STE 105
Mailing Address - Street 2:
Mailing Address - City:LAKE STEVENS
Mailing Address - State:WA
Mailing Address - Zip Code:98258-7976
Mailing Address - Country:US
Mailing Address - Phone:425-334-9137
Mailing Address - Fax:
Practice Address - Street 1:25 95TH DR NE STE 105
Practice Address - Street 2:
Practice Address - City:LAKE STEVENS
Practice Address - State:WA
Practice Address - Zip Code:98258-7976
Practice Address - Country:US
Practice Address - Phone:425-334-9137
Practice Address - Fax:425-377-9487
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-09-12
Last Update Date:2020-09-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage TherapistGroup - Single Specialty