Organization
ELLE'S ESSENTIAL MASSAGE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. ELLY BEACH CMT, LMP (OWNER)
(360) 425-1826
Entity
Organization
Contact information
Practice address
803 VANDERCOOK WAY, STE 2, LONGVIEW, WA 98632-4057
(360) 425-1826
Mailing address
803 VANDERCOOK WAY, STE 2, LONGVIEW, WA 98632-4057
(360) 425-1826
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
603544296
WA
Other
Enumeration date
10/20/2015
Last updated
10/20/2015
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