Provider Demographics
NPI:1528334422
Name:MASSAGE BY THE BAY LLC
Entity type:Organization
Organization Name:MASSAGE BY THE BAY LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/MASSAGE THERAPIST
Authorized Official - Prefix:MS
Authorized Official - First Name:MAUREEN
Authorized Official - Middle Name:MARIE
Authorized Official - Last Name:SEIM
Authorized Official - Suffix:
Authorized Official - Credentials:LMP
Authorized Official - Phone:253-238-3990
Mailing Address - Street 1:2601 70TH AVE W
Mailing Address - Street 2:SUITE A
Mailing Address - City:UNIVERSITY PLACE
Mailing Address - State:WA
Mailing Address - Zip Code:98466-5430
Mailing Address - Country:US
Mailing Address - Phone:253-238-3990
Mailing Address - Fax:253-238-1733
Practice Address - Street 1:2601 70TH AVE W
Practice Address - Street 2:SUITE A
Practice Address - City:UNIVERSITY PLACE
Practice Address - State:WA
Practice Address - Zip Code:98466-5430
Practice Address - Country:US
Practice Address - Phone:253-238-3990
Practice Address - Fax:253-238-1733
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-03-26
Last Update Date:2012-03-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA603177187261Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center