| Organization Name: | METAMORPHIC MASSAGE & WELLNESS INC |
| NPI Number: | 1114390762 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | MICHELLE LYNN HERRON (OWNER/LEAD MASSAGE THERAPIST) |
| Mailing Address: | 6342 Littlerock Rd Sw Tumwater |
| State: | WA US |
| Postal Code: | 985127332 |
| Phone Number: | 3605203011 |
| Fax Number: | |
| NPI Enumeration Date: | 11/04/2015 |
| NPI Last Update Date: | 11/04/2015 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 305R00000X |
| License Number: | MA00022554 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | WA |
| Taxonomy Type: | Managed Care Organizations |
| Taxonomy Classification: | Preferred Provider Organization |
| Taxonomy Specialization: | |
| Taxonomy Definition: | A group of physicians and/or hospitals who contract with an employer to provide services to their employees. In a PPO, the patient may got to the physician of his/her choice, even if that physician does not participate in the PPO, but the patient receives care at a lower benefit level. |