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Organization
NW MASSAGE THERAPY CORP
Active
Organization
NW MASSAGE THERAPY CORP
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DOUGLAS BLACK LMP (PRESIDENT)
(360) 903-9963
Entity
Organization
Contact information
Practice address
16906 SE 1ST ST STE 103, VANCOUVER, WA 98684-8512
(360) 903-9963
Mailing address
17413 NE 3RD ST, VANCOUVER, WA 98684-3730
(360) 903-9963
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
MA00011374
—
Other
Enumeration date
06/30/2017
Last updated
06/30/2017
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