Provider Demographics
NPI:1942622840
Name:BELLINGHAM MASSAGE WORKS
Entity Type:Organization
Organization Name:BELLINGHAM MASSAGE WORKS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:KEVIN
Authorized Official - Middle Name:
Authorized Official - Last Name:HARDMAN
Authorized Official - Suffix:
Authorized Official - Credentials:LMP
Authorized Official - Phone:360-223-1602
Mailing Address - Street 1:2101 CORNWALL AVE
Mailing Address - Street 2:SUITE 101
Mailing Address - City:BELLINGHAM
Mailing Address - State:WA
Mailing Address - Zip Code:98225-3649
Mailing Address - Country:US
Mailing Address - Phone:360-647-1900
Mailing Address - Fax:360-647-1542
Practice Address - Street 1:2101 CORNWALL AVE
Practice Address - Street 2:SUITE 101
Practice Address - City:BELLINGHAM
Practice Address - State:WA
Practice Address - Zip Code:98225-3649
Practice Address - Country:US
Practice Address - Phone:360-647-1900
Practice Address - Fax:360-647-1542
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-01-10
Last Update Date:2014-01-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMA00016978174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty