Provider Demographics
NPI:1801922513
Name:SERENE VIEW MASSAGE THERAPY
Entity type:Organization
Organization Name:SERENE VIEW MASSAGE THERAPY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:CHAD
Authorized Official - Middle Name:ERIC
Authorized Official - Last Name:TRIPLETT
Authorized Official - Suffix:
Authorized Official - Credentials:LMP
Authorized Official - Phone:425-290-6024
Mailing Address - Street 1:4803 84TH ST SW
Mailing Address - Street 2:
Mailing Address - City:MUKILTEO
Mailing Address - State:WA
Mailing Address - Zip Code:98275-3023
Mailing Address - Country:US
Mailing Address - Phone:425-290-6024
Mailing Address - Fax:425-290-8016
Practice Address - Street 1:4803 84TH ST SW
Practice Address - Street 2:
Practice Address - City:MUKILTEO
Practice Address - State:WA
Practice Address - Zip Code:98275-3023
Practice Address - Country:US
Practice Address - Phone:425-290-6024
Practice Address - Fax:425-290-8016
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-26
Last Update Date:2008-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMA00010193174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty