Organization
BLUE MOON MASSAGE STUDIO, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
CONNIE RYE LMP (OWNER)
(253) 509-0258
Entity
Organization
Contact information
Practice address
7700 PIONEER WAY, SUITE 101, GIG HARBOR, WA 98335-1156
(253) 509-0258
Mailing address
7700 PIONEER WAY, SUITE 101, GIG HARBOR, WA 98335-1156
(253) 509-0258
Taxonomy
Speciality
Code
Description
License number
State
171W00000X
Contractor
Primary
MA 00007473
WA
Other
Enumeration date
11/02/2013
Last updated
11/02/2013
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