Provider Demographics
NPI:1700468428
Name:BREATHING ESSENTIALS MYOFUNCTIONAL THERAPY, LLC
Entity Type:Organization
Organization Name:BREATHING ESSENTIALS MYOFUNCTIONAL THERAPY, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:SUSIE
Authorized Official - Middle Name:L
Authorized Official - Last Name:ESPINOSA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:253-220-5640
Mailing Address - Street 1:27731 246TH AVE SE
Mailing Address - Street 2:
Mailing Address - City:MAPLE VALLEY
Mailing Address - State:WA
Mailing Address - Zip Code:98038-2018
Mailing Address - Country:US
Mailing Address - Phone:253-220-5640
Mailing Address - Fax:
Practice Address - Street 1:27731 246TH AVE SE
Practice Address - Street 2:
Practice Address - City:MAPLE VALLEY
Practice Address - State:WA
Practice Address - Zip Code:98038-2018
Practice Address - Country:US
Practice Address - Phone:253-220-5640
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-04-22
Last Update Date:2021-04-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty