Organization
CUSTOMCARE MASSAGE, P.S., INC
Active
Organization
CUSTOMCARE MASSAGE, P.S., INC
Active
Other names
CustomCare Massage
Organization subpart
No
Provider details
NPI number
Authorized official
KAREN JEANETTE MONTEGNA (OFFICE MANAGER)
(509) 374-2600
Entity
Organization
Contact information
Practice address
8390 W GAGE BLVD, SUITE 207, KENNEWICK, WA 99336-8105
(509) 374-2600
(888) 814-3542
Mailing address
8390 W GAGE BLVD, SUITE 207, KENNEWICK, WA 99336-8105
(509) 374-2600
(888) 814-3542
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
MA00015620
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0164297
LABOR AND INDUSTRIES
WA
01
—
239007239006
AWHN
WA
Enumeration date
03/16/2007
Last updated
08/22/2020
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