Provider Demographics
NPI:1912323890
Name:CASCADES THERAPUTIC MASSAGE LLC
Entity Type:Organization
Organization Name:CASCADES THERAPUTIC MASSAGE LLC
Other - Org Name:ELEMENTS MASSAGE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:DANIEL
Authorized Official - Middle Name:
Authorized Official - Last Name:DIPASQUO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:415-509-6723
Mailing Address - Street 1:10575 NE 12TH ST
Mailing Address - Street 2:SUITE 17
Mailing Address - City:BELLEVUE
Mailing Address - State:WA
Mailing Address - Zip Code:98004-4362
Mailing Address - Country:US
Mailing Address - Phone:425-292-7888
Mailing Address - Fax:
Practice Address - Street 1:10575 NE 12TH ST
Practice Address - Street 2:SUITE 17
Practice Address - City:BELLEVUE
Practice Address - State:WA
Practice Address - Zip Code:98004-4362
Practice Address - Country:US
Practice Address - Phone:425-292-7888
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-03-14
Last Update Date:2014-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage TherapistGroup - Single Specialty