Provider Demographics
NPI:1003600073
Name:THE MYOSPACE OF SEATTLE
Entity type:Organization
Organization Name:THE MYOSPACE OF SEATTLE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OROFACIAL MYOFUNCTIONAL THERAPIST
Authorized Official - Prefix:
Authorized Official - First Name:NATALIA
Authorized Official - Middle Name:
Authorized Official - Last Name:WILLIAMS
Authorized Official - Suffix:
Authorized Official - Credentials:RDH, OMT
Authorized Official - Phone:813-944-7757
Mailing Address - Street 1:21022 47TH AVENUE CT E
Mailing Address - Street 2:
Mailing Address - City:SPANAWAY
Mailing Address - State:WA
Mailing Address - Zip Code:98387-6079
Mailing Address - Country:US
Mailing Address - Phone:813-944-7757
Mailing Address - Fax:
Practice Address - Street 1:21022 47TH AVENUE CT E
Practice Address - Street 2:
Practice Address - City:SPANAWAY
Practice Address - State:WA
Practice Address - Zip Code:98387-6079
Practice Address - Country:US
Practice Address - Phone:813-944-7757
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-04-07
Last Update Date:2025-04-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes124Q00000XDental ProvidersDental HygienistGroup - Single Specialty