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Organization

A MOMENT FOR YOU PLLC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
MR. BRYAN T DEFORREST MA (MANAGER/OWNER/LMP)
(206) 601-8334
Entity
Organization

Contact information

Practice address
650 S ORCAS ST STE 219, SEATTLE, WA 98108-2652
(206) 456-4463
(855) 272-1649
Mailing address
650 S ORCAS ST, SUITE 219, SEATTLE, WA 98108
(206) 456-4463
(855) 272-1649

Taxonomy

Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
MA60075925
WA
225700000X
Massage Therapist
MA60306672
WA

Other

Enumeration date
10/28/2014
Last updated
08/29/2017
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