Provider Demographics
NPI:1851750863
Name:SEN THAI MASSAGE
Entity Type:Organization
Organization Name:SEN THAI MASSAGE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:BRITTANY
Authorized Official - Middle Name:
Authorized Official - Last Name:QUON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:206-802-8560
Mailing Address - Street 1:2440 140TH AVE NE APT 17
Mailing Address - Street 2:
Mailing Address - City:BELLEVUE
Mailing Address - State:WA
Mailing Address - Zip Code:98005-1856
Mailing Address - Country:US
Mailing Address - Phone:206-802-8560
Mailing Address - Fax:
Practice Address - Street 1:700 NW 42ND ST
Practice Address - Street 2:
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98107-4505
Practice Address - Country:US
Practice Address - Phone:206-802-8560
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-02-18
Last Update Date:2016-02-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMA 60159285261QH0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QH0100XAmbulatory Health Care FacilitiesClinic/CenterHealth Service