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Organization
LAVENDERA MASSAGE LLC
Active
Organization
LAVENDERA MASSAGE LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. RICHARD A DAVENPORT LMP (OWNER)
(360) 378-3637
Entity
Organization
Contact information
Practice address
285 SPRING ST, FRIDAY HARBOR, WA 98250
(360) 378-3637
Mailing address
PO BOX 2645, FRIDAY HARBOR, WA 98250-2645
(360) 378-3637
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
MA60091736
WA
Other
Enumeration date
01/14/2015
Last updated
01/14/2015
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