Provider Demographics
NPI:1992295703
Name:SAGE-TATE, CELESTE MARIE (MASSAGE THERAPIST)
Entity type:Individual
Prefix:
First Name:CELESTE
Middle Name:MARIE
Last Name:SAGE-TATE
Suffix:
Gender:F
Credentials:MASSAGE THERAPIST
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:22328 88TH WAY S UNIT T101
Mailing Address - Street 2:
Mailing Address - City:KENT
Mailing Address - State:WA
Mailing Address - Zip Code:98031-2821
Mailing Address - Country:US
Mailing Address - Phone:303-324-9848
Mailing Address - Fax:
Practice Address - Street 1:26404 104TH AVE SE
Practice Address - Street 2:
Practice Address - City:KENT
Practice Address - State:WA
Practice Address - Zip Code:98030-7053
Practice Address - Country:US
Practice Address - Phone:303-324-9848
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-05-16
Last Update Date:2022-08-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMA00008000225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist