Organization
AVALON MASSAGE & DAY SPA LTD
Active
Other names
Mindy's Massage
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. MINDY SUE WIEGEL LMP (OWNER)
(360) 582-9977
Entity
Organization
Contact information
Practice address
660 W EVERGREEN FARM WAY, SEQUIM, WA 98382-5097
(360) 582-9977
(360) 582-9972
Mailing address
PO BOX 7, CARLSBORG, WA 98324
(360) 582-9977
(360) 582-9972
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
MA00009684
WA
225700000X
Massage Therapist
—
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
157675
—
WA
01
—
204592204592
PREMENA BC
WA
01
—
W15428
REGENCE
WA
Enumeration date
07/05/2006
Last updated
08/22/2020
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