Provider Demographics
NPI:1942425616
Name:LOTUS WASHINGTON INC
Entity Type:Organization
Organization Name:LOTUS WASHINGTON INC
Other - Org Name:LA SERENITY SPA
Other - Org Type:Doing Business As
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:MR
Authorized Official - First Name:MUNETSUGU
Authorized Official - Middle Name:
Authorized Official - Last Name:YOKOBE
Authorized Official - Suffix:
Authorized Official - Credentials:LMP
Authorized Official - Phone:425-990-0043
Mailing Address - Street 1:10301 NE 10TH ST
Mailing Address - Street 2:
Mailing Address - City:BELLEVUE
Mailing Address - State:WA
Mailing Address - Zip Code:98004-4213
Mailing Address - Country:US
Mailing Address - Phone:425-990-0043
Mailing Address - Fax:425-990-8043
Practice Address - Street 1:10301 NE 10TH ST
Practice Address - Street 2:
Practice Address - City:BELLEVUE
Practice Address - State:WA
Practice Address - Zip Code:98004-4213
Practice Address - Country:US
Practice Address - Phone:425-990-0043
Practice Address - Fax:425-990-8043
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-16
Last Update Date:2010-10-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMA00013284225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage TherapistGroup - Single Specialty