Provider Demographics
NPI:1225862527
Name:YVETTES MASSAGE
Entity type:Organization
Organization Name:YVETTES MASSAGE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MASSAGE THERAPIST/OWNER
Authorized Official - Prefix:
Authorized Official - First Name:YVETTE
Authorized Official - Middle Name:
Authorized Official - Last Name:BANKS
Authorized Official - Suffix:
Authorized Official - Credentials:LMT
Authorized Official - Phone:360-869-6551
Mailing Address - Street 1:4619 NE 112TH AVE APT D202
Mailing Address - Street 2:
Mailing Address - City:VANCOUVER
Mailing Address - State:WA
Mailing Address - Zip Code:98682-5403
Mailing Address - Country:US
Mailing Address - Phone:360-869-6551
Mailing Address - Fax:503-564-1953
Practice Address - Street 1:516 SE CHKALOV DR STE 49
Practice Address - Street 2:
Practice Address - City:VANCOUVER
Practice Address - State:WA
Practice Address - Zip Code:98683-5277
Practice Address - Country:US
Practice Address - Phone:360-869-6551
Practice Address - Fax:503-564-1953
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-08-28
Last Update Date:2024-08-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage TherapistGroup - Single Specialty