Provider Demographics
NPI:1912240961
Name:TREAT YOURSELF DAY SPA
Entity Type:Organization
Organization Name:TREAT YOURSELF DAY SPA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:SHANNON
Authorized Official - Middle Name:
Authorized Official - Last Name:BRADSHAW
Authorized Official - Suffix:
Authorized Official - Credentials:LMP
Authorized Official - Phone:425-697-0823
Mailing Address - Street 1:20833 67TH AVE W STE 301
Mailing Address - Street 2:
Mailing Address - City:LYNNWOOD
Mailing Address - State:WA
Mailing Address - Zip Code:98036-7365
Mailing Address - Country:US
Mailing Address - Phone:425-697-0823
Mailing Address - Fax:425-673-9410
Practice Address - Street 1:20833 67TH AVE W STE 301
Practice Address - Street 2:
Practice Address - City:LYNNWOOD
Practice Address - State:WA
Practice Address - Zip Code:98036-7365
Practice Address - Country:US
Practice Address - Phone:425-697-0823
Practice Address - Fax:425-673-9410
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-03-28
Last Update Date:2016-11-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage TherapistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA1215144183OtherMASSAGE
WA1760933998OtherMASSAGE