Provider Demographics
NPI:1932519626
Name:MARY D'AURIA
Entity Type:Organization
Organization Name:MARY D'AURIA
Other - Org Name:KE HAKU KAIYAH
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:MARY
Authorized Official - Middle Name:
Authorized Official - Last Name:DAURIA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:509-370-1113
Mailing Address - Street 1:12702 E CONNOR RD
Mailing Address - Street 2:
Mailing Address - City:VALLEYFORD
Mailing Address - State:WA
Mailing Address - Zip Code:99036-9792
Mailing Address - Country:US
Mailing Address - Phone:509-370-1113
Mailing Address - Fax:509-465-0451
Practice Address - Street 1:12702 E CONNOR RD
Practice Address - Street 2:
Practice Address - City:VALLEYFORD
Practice Address - State:WA
Practice Address - Zip Code:99036-9792
Practice Address - Country:US
Practice Address - Phone:509-370-1113
Practice Address - Fax:509-465-0451
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-05-02
Last Update Date:2014-05-02
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