Provider Demographics
NPI:1699483198
Name:MARIE BENOIT LMP
Entity type:Organization
Organization Name:MARIE BENOIT LMP
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER/LICENSED MASSAGE THERAPIST
Authorized Official - Prefix:
Authorized Official - First Name:MARIE
Authorized Official - Middle Name:
Authorized Official - Last Name:BENOIT
Authorized Official - Suffix:
Authorized Official - Credentials:MA60042832
Authorized Official - Phone:425-314-0609
Mailing Address - Street 1:5248 LONGBOW RD
Mailing Address - Street 2:
Mailing Address - City:KING GEORGE
Mailing Address - State:VA
Mailing Address - Zip Code:22485-3169
Mailing Address - Country:US
Mailing Address - Phone:425-314-0609
Mailing Address - Fax:425-320-4091
Practice Address - Street 1:9623 32ND ST SE # D113D115
Practice Address - Street 2:
Practice Address - City:LAKE STEVENS
Practice Address - State:WA
Practice Address - Zip Code:98258-5779
Practice Address - Country:US
Practice Address - Phone:425-314-0609
Practice Address - Fax:425-320-4091
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:MARIE BENOIT LMP, LAKESIDE MASSAGE AND WELLNESS STUDIO LLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2022-11-14
Last Update Date:2022-12-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage TherapistGroup - Multi-Specialty