Provider Demographics
NPI:1134433808
Name:PUGET SOUND THERAPEUTIC MASSAGE
Entity type:Organization
Organization Name:PUGET SOUND THERAPEUTIC MASSAGE
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:ELLEN
Authorized Official - Middle Name:A
Authorized Official - Last Name:PARKER
Authorized Official - Suffix:
Authorized Official - Credentials:LMP
Authorized Official - Phone:206-781-9541
Mailing Address - Street 1:1800 NW MARKET ST STE 200
Mailing Address - Street 2:
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98107-3900
Mailing Address - Country:US
Mailing Address - Phone:206-781-9541
Mailing Address - Fax:206-781-3069
Practice Address - Street 1:1800 NW MARKET ST STE 200
Practice Address - Street 2:
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98107-3900
Practice Address - Country:US
Practice Address - Phone:206-781-9541
Practice Address - Fax:206-781-3069
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-08-04
Last Update Date:2010-08-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMA 00017173174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty