Provider Demographics
NPI:1982906640
Name:THE BRICKHOUSE MASSAGE AND COFFEE BAR
Entity Type:Organization
Organization Name:THE BRICKHOUSE MASSAGE AND COFFEE BAR
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SPA MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:JILL
Authorized Official - Middle Name:
Authorized Official - Last Name:HENDRICKS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:509-891-1999
Mailing Address - Street 1:14222 E SPRAGUE AVE
Mailing Address - Street 2:
Mailing Address - City:SPOKANE VALLEY
Mailing Address - State:WA
Mailing Address - Zip Code:99216-2188
Mailing Address - Country:US
Mailing Address - Phone:509-891-1999
Mailing Address - Fax:
Practice Address - Street 1:14222 E SPRAGUE AVE
Practice Address - Street 2:
Practice Address - City:SPOKANE VALLEY
Practice Address - State:WA
Practice Address - Zip Code:99216-2188
Practice Address - Country:US
Practice Address - Phone:509-891-1999
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-11-30
Last Update Date:2010-11-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage TherapistGroup - Single Specialty