Organization
EVERGREEN MASSAGE THERAPY, PS
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. TERI GREEN LMP (OWNER/LICENSED MASSAGE THERAPIST)
(253) 850-2800
Entity
Organization
Contact information
Practice address
1048 W JAMES ST STE 104, KENT, WA 98032-4600
(253) 850-2800
(253) 850-2805
Mailing address
1048 W JAMES ST STE 104, KENT, WA 98032-4600
(253) 850-2800
(253) 850-2805
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
MA00016443
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1003032434
NPI
WA
01
—
1548402183
NPI
WA
01
—
1568786531
NPI
WA
01
—
1649571944
NPI
WA
01
—
1790833879
NPI
WA
01
—
1851442354
NPI
WA
01
—
1992862007
NPI
WA
Enumeration date
02/06/2012
Last updated
02/06/2012
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