Provider Demographics
NPI:1457742280
Name:ZENERGY MASSAGE CLINIC
Entity Type:Organization
Organization Name:ZENERGY MASSAGE CLINIC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:LESA
Authorized Official - Middle Name:JEAN
Authorized Official - Last Name:BOWLES
Authorized Official - Suffix:
Authorized Official - Credentials:LMP
Authorized Official - Phone:253-572-9588
Mailing Address - Street 1:1310 N I ST SUITE B
Mailing Address - Street 2:
Mailing Address - City:TACOMA
Mailing Address - State:WA
Mailing Address - Zip Code:98403
Mailing Address - Country:US
Mailing Address - Phone:253-572-9588
Mailing Address - Fax:
Practice Address - Street 1:1310 N I ST SUITE B
Practice Address - Street 2:
Practice Address - City:TACOMA
Practice Address - State:WA
Practice Address - Zip Code:98403
Practice Address - Country:US
Practice Address - Phone:253-572-9588
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-02-16
Last Update Date:2015-02-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMA00019264172V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes172V00000XOther Service ProvidersCommunity Health WorkerGroup - Single Specialty