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Organization
SELF BALANCE MASSAGE
Active
Organization
SELF BALANCE MASSAGE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
TERESA L BONAWITZ LMP (CO-OWNER)
(360) 202-7085
Entity
Organization
Contact information
Practice address
5107 NE 94TH AVE STE A, VANCOUVER, WA 98662-6188
(360) 202-7085
(801) 501-7085
Mailing address
5107 NE 94TH AVE STE A, VANCOUVER, WA 98662-6188
(360) 202-7085
(801) 501-7085
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
MA60042214
WA
Other
Enumeration date
03/18/2014
Last updated
03/18/2014
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