Provider Demographics
NPI:1952058406
Name:DANIEL SANSONE MASSAGE PLLC
Entity Type:Organization
Organization Name:DANIEL SANSONE MASSAGE PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/PROVIDER
Authorized Official - Prefix:
Authorized Official - First Name:DANIEL
Authorized Official - Middle Name:LEE
Authorized Official - Last Name:SANSONE
Authorized Official - Suffix:
Authorized Official - Credentials:LMT
Authorized Official - Phone:317-607-4590
Mailing Address - Street 1:2520 E MARION ST
Mailing Address - Street 2:
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98122-4943
Mailing Address - Country:US
Mailing Address - Phone:317-607-4590
Mailing Address - Fax:
Practice Address - Street 1:1812 E MADISON ST STE 40
Practice Address - Street 2:
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98122-2818
Practice Address - Country:US
Practice Address - Phone:317-607-4590
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-03-04
Last Update Date:2022-03-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage TherapistGroup - Single Specialty