Provider Demographics
NPI:1528234341
Name:MADELINE'S MASSAGE, INC.
Entity type:Organization
Organization Name:MADELINE'S MASSAGE, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:MADELINE
Authorized Official - Middle Name:
Authorized Official - Last Name:BEAUVAIS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:360-608-4370
Mailing Address - Street 1:PO BOX 842
Mailing Address - Street 2:
Mailing Address - City:REDMOND
Mailing Address - State:OR
Mailing Address - Zip Code:97756-0175
Mailing Address - Country:US
Mailing Address - Phone:360-608-4370
Mailing Address - Fax:541-526-5110
Practice Address - Street 1:8515 NE HAZEL DELL AVE
Practice Address - Street 2:SUITE C
Practice Address - City:VANCOUVER
Practice Address - State:WA
Practice Address - Zip Code:98665-8144
Practice Address - Country:US
Practice Address - Phone:360-608-4370
Practice Address - Fax:541-526-5110
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-05-01
Last Update Date:2014-01-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage TherapistGroup - Single Specialty