Provider Demographics
NPI:1811270838
Name:ACCLAIM BODY CARE LLC
Entity type:Organization
Organization Name:ACCLAIM BODY CARE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:BUSINESS OWNER
Authorized Official - Prefix:MS
Authorized Official - First Name:CAROLINE
Authorized Official - Middle Name:A
Authorized Official - Last Name:ACOSTA-DRAKE
Authorized Official - Suffix:
Authorized Official - Credentials:LMP
Authorized Official - Phone:206-715-1318
Mailing Address - Street 1:PO BOX 33185
Mailing Address - Street 2:
Mailing Address - City:SHORELINE
Mailing Address - State:WA
Mailing Address - Zip Code:98133-0185
Mailing Address - Country:US
Mailing Address - Phone:206-715-1318
Mailing Address - Fax:206-402-6548
Practice Address - Street 1:17517 15TH AVE NE
Practice Address - Street 2:SUITE B
Practice Address - City:SHORELINE
Practice Address - State:WA
Practice Address - Zip Code:98155-3801
Practice Address - Country:US
Practice Address - Phone:206-715-1318
Practice Address - Fax:206-402-6548
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-09-26
Last Update Date:2011-09-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMA 00015223225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage TherapistGroup - Single Specialty