Provider Demographics
NPI:1598273625
Name:WARRIOR MASSAGE PLLC
Entity type:Organization
Organization Name:WARRIOR MASSAGE PLLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:JESSE
Authorized Official - Middle Name:TYLER
Authorized Official - Last Name:JONES
Authorized Official - Suffix:
Authorized Official - Credentials:LMT
Authorized Official - Phone:202-413-6999
Mailing Address - Street 1:PO BOX 4484
Mailing Address - Street 2:
Mailing Address - City:EVERETT
Mailing Address - State:WA
Mailing Address - Zip Code:98204-0048
Mailing Address - Country:US
Mailing Address - Phone:202-413-6999
Mailing Address - Fax:425-348-0478
Practice Address - Street 1:11611 AIRPORT RD STE 204
Practice Address - Street 2:
Practice Address - City:EVERETT
Practice Address - State:WA
Practice Address - Zip Code:98204-3782
Practice Address - Country:US
Practice Address - Phone:202-413-6999
Practice Address - Fax:425-348-0478
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-01-10
Last Update Date:2018-01-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage TherapistGroup - Single Specialty