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Organization
MD THERAPY & MASSAGE LLC
Active
Organization
MD THERAPY & MASSAGE LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. DERICK MOODY (OWNER)
(360) 908-7559
Entity
Organization
Contact information
Practice address
5401 6TH AVE STE 300, TACOMA, WA 98406-2618
(360) 908-7559
Mailing address
14113 SE 177TH ST APT J305, RENTON, WA 98058-9251
(360) 908-7559
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
MA60298052
WA
Other
Enumeration date
11/05/2014
Last updated
11/05/2014
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