Organization Name: | LIFECARE THERAPEUTIC MASSAGE AND HEALTH CLINIC |
NPI Number: | 1659623445 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | WILLIAM TIM KELLEY (OWNER/SR. THERAPIST) |
Mailing Address: | 7981 168th Ave Ne Ste 140 Redmond |
State: | WA US |
Postal Code: | 98052 |
Phone Number: | 4258614600 |
Fax Number: | |
NPI Enumeration Date: | 10/04/2012 |
NPI Last Update Date: | 10/09/2012 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 225700000X |
License Number: | MA00013010 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | WA |
Taxonomy Type: | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
Taxonomy Classification: | Massage Therapist |
Taxonomy Specialization: | |
Taxonomy Definition: | An individual trained in the manipulation of tissues (as by rubbing, stroking, kneading, or tapping) with the hand or an instrument for remedial or hygienic purposes. |