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Organization
MAI PEN RAI MASSAGE
Active
Organization
MAI PEN RAI MASSAGE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
AMANDA MICHEL LMP (LICENSED MASSAGE PRACTITIONER)
(360) 513-4472
Entity
Organization
Contact information
Practice address
108 SE 124TH AVE STE 24, VANCOUVER, WA 98684-6015
(360) 513-4472
(360) 885-4944
Mailing address
508 SE 124TH AVE, VANCOUVER, WA 98664-4053
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
MA00021243
WA
Other
Enumeration date
05/03/2012
Last updated
05/03/2012
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