# EVERGREEN MASSAGE & WELLNESS

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Edmonds Massage Center
- **Organization subpart:** No

## Provider details

- **NPI number:** 1871097360
- **Authorized official:** JESSIE YAO SOUTHWICK (MANAGER/OWNER)
- **Authorized official phone:** (425) 776-1056

## Contact information

- **Practice address:** 6808 220TH ST SW STE 203, MOUNTLAKE TERRACE, WA 98043-2187
- **Practice address phone:** (425) 776-1056
- **Mailing address:** 6808 220TH ST SW STE 203, MOUNTLAKE TERRACE, WA 98043-2187

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 208100000X | Physical Medicine & Rehabilitation Physician | — | NULL | Yes |
| 208100000X | Physical Medicine & Rehabilitation Physician | — | — | Yes |

## Other

- **Enumeration date:** 03/20/2018
- **Last updated:** 03/20/2018