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Organization
STILL LIFE MASSAGE AND FLOAT
Active
Organization
STILL LIFE MASSAGE AND FLOAT
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. SHANNON C FULLER LMP (OWNER)
(360) 647-2805
Entity
Organization
Contact information
Practice address
19 BELLWETHER WAY STE 101, BELLINGHAM, WA 98225-2966
(360) 647-2805
Mailing address
19 BELLWETHER WAY STE 101, BELLINGHAM, WA 98225-2966
(360) 647-2805
(360) 734-4148
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
MA00017027
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1194853036
PERSONAL NPI
WA
Enumeration date
05/14/2013
Last updated
12/15/2015
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