Provider Demographics
NPI:1558173872
Name:PURE ESCAPE SPA
Entity type:Organization
Organization Name:PURE ESCAPE SPA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:LISA
Authorized Official - Middle Name:D
Authorized Official - Last Name:CRATER-COEN
Authorized Official - Suffix:
Authorized Official - Credentials:LMT, RN
Authorized Official - Phone:253-630-1332
Mailing Address - Street 1:13106 SE 240TH ST STE 202
Mailing Address - Street 2:
Mailing Address - City:KENT
Mailing Address - State:WA
Mailing Address - Zip Code:98031-9211
Mailing Address - Country:US
Mailing Address - Phone:425-269-6575
Mailing Address - Fax:253-639-4809
Practice Address - Street 1:13106 SE 240TH ST STE 202
Practice Address - Street 2:
Practice Address - City:KENT
Practice Address - State:WA
Practice Address - Zip Code:98031-9211
Practice Address - Country:US
Practice Address - Phone:253-630-1332
Practice Address - Fax:253-639-4809
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-01-23
Last Update Date:2025-01-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage TherapistGroup - Single Specialty