Organization
BLUE WAVE BODYWORK
Active
Organization
BLUE WAVE BODYWORK
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MISTY LEE (LMT)
(503) 320-7899
Entity
Organization
Contact information
Practice address
12014 SE MILL PLAIN BLVD STE 200, VANCOUVER, WA 98684-4044
(503) 320-7899
(360) 836-8448
Mailing address
12014 SE MILL PLAIN BLVD STE 200, VANCOUVER, WA 98684-4044
(503) 320-7899
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
MA60811941
WA
Other
Enumeration date
07/23/2018
Last updated
07/23/2018
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