Provider Demographics
NPI:1780089748
Name:SERENITY HOLISTIC HEALTH & MASSAGE
Entity type:Organization
Organization Name:SERENITY HOLISTIC HEALTH & MASSAGE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MRS
Authorized Official - First Name:MEGAN
Authorized Official - Middle Name:
Authorized Official - Last Name:DOUGLAS
Authorized Official - Suffix:
Authorized Official - Credentials:LMP
Authorized Official - Phone:253-228-4681
Mailing Address - Street 1:706 MARKET ST
Mailing Address - Street 2:
Mailing Address - City:TACOMA
Mailing Address - State:WA
Mailing Address - Zip Code:98402-3712
Mailing Address - Country:US
Mailing Address - Phone:253-507-7121
Mailing Address - Fax:253-267-1607
Practice Address - Street 1:1919 N PEARL ST STE A4
Practice Address - Street 2:
Practice Address - City:TACOMA
Practice Address - State:WA
Practice Address - Zip Code:98406-2456
Practice Address - Country:US
Practice Address - Phone:253-761-0930
Practice Address - Fax:253-761-8746
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-11-03
Last Update Date:2014-11-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMA00018906174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty