Organization · NPI-2

Massage Radiance

Clinic/Center · Mount Vernon, WA

NPI number1518153378
StatusActive
Last updated in NPPESNov 18, 2015

Details

NPI
1518153378
Entity type
Organization (NPI-2)
Legal business name
Massage Radiance
Organization subpart
No
Enumeration date
Sep 14, 2007
Last updated
Nov 18, 2015

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
261Q00000X Clinic/CenterMA00024680WAYes

Practice location

2108 Riverside Dr
Mount Vernon, WA 98273-5406

Phone 360-540-1900

Mailing address

2420 E Meadow Blvd
Mount Vernon, WA 98273-2374

Phone 360-540-1900

Authorized official

Renee C. Palmer
Owner/Manager
3605401900

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