Organization
CROSSFUNCTION SPORTS MASSAGE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JENNY MAPES LMT (OWNER)
(425) 418-8588
Entity
Organization
Contact information
Practice address
16000 BOTHELL EVERETT HWY STE 161, MILL CREEK, WA 98012-1742
(425) 595-3436
Mailing address
2510 164TH ST SW APT F107, LYNNWOOD, WA 98087-7839
(425) 772-5671
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1316476112
—
WA
Enumeration date
10/12/2018
Last updated
10/12/2018
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