Provider Demographics
NPI:1154805109
Name:SIGNATURE MASSAGE
Entity type:Organization
Organization Name:SIGNATURE MASSAGE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:BREANNA
Authorized Official - Middle Name:
Authorized Official - Last Name:ZEIS
Authorized Official - Suffix:
Authorized Official - Credentials:LMT
Authorized Official - Phone:509-954-5018
Mailing Address - Street 1:624 W HASTINGS RD STE 14
Mailing Address - Street 2:
Mailing Address - City:SPOKANE
Mailing Address - State:WA
Mailing Address - Zip Code:99218-2877
Mailing Address - Country:US
Mailing Address - Phone:509-954-5018
Mailing Address - Fax:509-241-0815
Practice Address - Street 1:624 W HASTINGS RD STE 16
Practice Address - Street 2:
Practice Address - City:SPOKANE
Practice Address - State:WA
Practice Address - Zip Code:99218-2877
Practice Address - Country:US
Practice Address - Phone:509-954-5018
Practice Address - Fax:509-240-0815
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-09-16
Last Update Date:2019-04-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage TherapistGroup - Single Specialty