Provider Demographics
NPI:1205069333
Name:ACCLAIM BODY CARE, LLC
Entity type:Organization
Organization Name:ACCLAIM BODY CARE, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/MEMBER
Authorized Official - Prefix:MISS
Authorized Official - First Name:CAROLINE
Authorized Official - Middle Name:
Authorized Official - Last Name:ACOSTA-DRAKE
Authorized Official - Suffix:
Authorized Official - Credentials:LMPC
Authorized Official - Phone:206-715-1318
Mailing Address - Street 1:P.O.BOX 33185
Mailing Address - Street 2:
Mailing Address - City:SHORELINE
Mailing Address - State:WA
Mailing Address - Zip Code:98133
Mailing Address - Country:US
Mailing Address - Phone:206-715-1318
Mailing Address - Fax:206-402-6548
Practice Address - Street 1:17517 15TH AVE.
Practice Address - Street 2:SUITE B
Practice Address - City:SHORELINE
Practice Address - State:WA
Practice Address - Zip Code:98155
Practice Address - Country:US
Practice Address - Phone:206-715-1318
Practice Address - Fax:206-402-6548
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-08-24
Last Update Date:2009-08-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA602924167225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage TherapistGroup - Multi-Specialty