Organization
AT VANCOUVER MASSAGE, LLC
Active
Other names
At Vancouver Massage
Organization subpart
No
Provider details
NPI number
Authorized official
MS. JEAN A KONCOS LMT (OWNER)
(360) 635-3477
Entity
Organization
Contact information
Practice address
1508 BROADWAY ST, VANCOUVER, WA 98663-3434
(360) 635-3477
(844) 682-7291
Mailing address
204 E 16TH ST, VANCOUVER, WA 98663-3409
(360) 635-3477
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
MA00019183
WA
Other
Enumeration date
03/21/2018
Last updated
10/09/2023
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