Provider Demographics
NPI:1386334225
Name:BODYWISE MASSAGE INC
Entity type:Organization
Organization Name:BODYWISE MASSAGE INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT/LMT/ADMINISTRATION
Authorized Official - Prefix:
Authorized Official - First Name:CINDY
Authorized Official - Middle Name:LOU
Authorized Official - Last Name:CARMICHAEL TAYLOR
Authorized Official - Suffix:
Authorized Official - Credentials:LMT
Authorized Official - Phone:253-564-4284
Mailing Address - Street 1:2811 BRIDGEPORT WAY W STE 17
Mailing Address - Street 2:
Mailing Address - City:UNIVERSITY PLACE
Mailing Address - State:WA
Mailing Address - Zip Code:98466-4602
Mailing Address - Country:US
Mailing Address - Phone:253-564-4284
Mailing Address - Fax:253-251-3156
Practice Address - Street 1:2811 BRIDGEPORT WAY W STE 17
Practice Address - Street 2:
Practice Address - City:UNIVERSITY PLACE
Practice Address - State:WA
Practice Address - Zip Code:98466-4602
Practice Address - Country:US
Practice Address - Phone:253-564-4284
Practice Address - Fax:253-251-3156
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-05-12
Last Update Date:2023-05-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage TherapistGroup - Multi-Specialty