Provider Demographics
NPI:1134767189
Name:LUNA MASSAGE AND WELLNESS
Entity type:Organization
Organization Name:LUNA MASSAGE AND WELLNESS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/ LMT
Authorized Official - Prefix:
Authorized Official - First Name:PATRICIA
Authorized Official - Middle Name:L
Authorized Official - Last Name:MCQUINN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:206-546-6666
Mailing Address - Street 1:7631 212TH ST SW STE 106B
Mailing Address - Street 2:
Mailing Address - City:EDMONDS
Mailing Address - State:WA
Mailing Address - Zip Code:98026-7565
Mailing Address - Country:US
Mailing Address - Phone:206-546-6666
Mailing Address - Fax:206-400-2702
Practice Address - Street 1:7631 212TH ST SW STE 106B
Practice Address - Street 2:
Practice Address - City:EDMONDS
Practice Address - State:WA
Practice Address - Zip Code:98026-7565
Practice Address - Country:US
Practice Address - Phone:206-546-6666
Practice Address - Fax:206-400-2702
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-12-19
Last Update Date:2019-12-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage TherapistGroup - Single Specialty