Organization
BODYWORK DEVINE LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KRISTIN TAYLOR LMP (OWNER)
(360) 798-3105
Entity
Organization
Contact information
Practice address
8507 S 5TH ST STE 104, RIDGEFIELD, WA 98642-3422
(360) 887-5839
Mailing address
34400 NE TAYLOR VALLEY RD, LA CENTER, WA 98629-3408
(360) 798-3105
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
MA60188254
WA
Other
Enumeration date
08/02/2018
Last updated
08/02/2018
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