Provider Demographics
NPI:1588963672
Name:STONEWORKS MASSAGE, LLC
Entity type:Organization
Organization Name:STONEWORKS MASSAGE, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGING MEMBER
Authorized Official - Prefix:
Authorized Official - First Name:MELANIE
Authorized Official - Middle Name:
Authorized Official - Last Name:CAIN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:509-783-6677
Mailing Address - Street 1:3180 W CLEARWATER AVE
Mailing Address - Street 2:STE F
Mailing Address - City:KENNEWICK
Mailing Address - State:WA
Mailing Address - Zip Code:99336-2767
Mailing Address - Country:US
Mailing Address - Phone:509-783-6677
Mailing Address - Fax:509-783-6675
Practice Address - Street 1:3180 W CLEARWATER AVE
Practice Address - Street 2:STE F
Practice Address - City:KENNEWICK
Practice Address - State:WA
Practice Address - Zip Code:99336-2767
Practice Address - Country:US
Practice Address - Phone:509-783-6677
Practice Address - Fax:509-783-6675
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-03-15
Last Update Date:2012-07-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage TherapistGroup - Single Specialty