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Organization
MIRA AQUA MASSAGE
Active
Organization
MIRA AQUA MASSAGE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
AMANDA T MCGEE (OWNER/MASSAGE THERAPIST)
(206) 941-4543
Entity
Organization
Contact information
Practice address
3516 204TH ST SW, APT A201, LYNNWOOD, WA 98036-9327
(206) 941-4543
Mailing address
3516 204TH ST SW, APT A201, LYNNWOOD, WA 98036-9327
(206) 941-4543
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
MA60129874
WA
Other
Enumeration date
11/07/2012
Last updated
11/07/2012
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