Provider Demographics
NPI:1194162487
Name:MAKE TIME FOR YOU MASSAGE LLC
Entity type:Organization
Organization Name:MAKE TIME FOR YOU MASSAGE LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER/LMP
Authorized Official - Prefix:
Authorized Official - First Name:DANITA
Authorized Official - Middle Name:R
Authorized Official - Last Name:JEFFERSON
Authorized Official - Suffix:
Authorized Official - Credentials:LMP
Authorized Official - Phone:253-267-5238
Mailing Address - Street 1:10202 PACIFIC AVE S STE 215
Mailing Address - Street 2:
Mailing Address - City:TACOMA
Mailing Address - State:WA
Mailing Address - Zip Code:98444-6573
Mailing Address - Country:US
Mailing Address - Phone:253-267-5238
Mailing Address - Fax:253-267-5238
Practice Address - Street 1:10202 PACIFIC AVE S STE 215
Practice Address - Street 2:
Practice Address - City:TACOMA
Practice Address - State:WA
Practice Address - Zip Code:98444-6573
Practice Address - Country:US
Practice Address - Phone:253-267-5238
Practice Address - Fax:253-267-5238
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-05-28
Last Update Date:2013-05-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage TherapistGroup - Single Specialty