Provider Demographics
NPI:1154160398
Name:SALT AND STONE THERAPEUTIC MASSAGE
Entity type:Organization
Organization Name:SALT AND STONE THERAPEUTIC MASSAGE
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:LMT
Authorized Official - Prefix:MRS
Authorized Official - First Name:BONNIE
Authorized Official - Middle Name:
Authorized Official - Last Name:HARRINGTON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:509-378-7397
Mailing Address - Street 1:8927 W TUCANNON AVE STE 102
Mailing Address - Street 2:
Mailing Address - City:KENNEWICK
Mailing Address - State:WA
Mailing Address - Zip Code:99336-7176
Mailing Address - Country:US
Mailing Address - Phone:509-378-7397
Mailing Address - Fax:509-543-6851
Practice Address - Street 1:8927 W TUCANNON AVE STE 102
Practice Address - Street 2:
Practice Address - City:KENNEWICK
Practice Address - State:WA
Practice Address - Zip Code:99336-7176
Practice Address - Country:US
Practice Address - Phone:509-378-7397
Practice Address - Fax:509-543-6851
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:SALT AND STONE THERAPEUTIC MASSAGE LLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2024-05-20
Last Update Date:2024-05-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage TherapistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA1447568142OtherINDIVIDUAL NPI