Provider Demographics
NPI:1992475305
Name:BODY EFFECTS WELLNESS P.L.L.C.
Entity type:Organization
Organization Name:BODY EFFECTS WELLNESS P.L.L.C.
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER & LMT
Authorized Official - Prefix:
Authorized Official - First Name:AMANDA
Authorized Official - Middle Name:
Authorized Official - Last Name:BAKER
Authorized Official - Suffix:
Authorized Official - Credentials:LMT
Authorized Official - Phone:425-219-7355
Mailing Address - Street 1:22627 BOTHELL EVERETT HWY
Mailing Address - Street 2:STE C, #104
Mailing Address - City:BOTHELL
Mailing Address - State:WA
Mailing Address - Zip Code:98021-8499
Mailing Address - Country:US
Mailing Address - Phone:425-219-7355
Mailing Address - Fax:
Practice Address - Street 1:22627 BOTHELL EVERETT HWY
Practice Address - Street 2:STE C, #104
Practice Address - City:BOTHELL
Practice Address - State:WA
Practice Address - Zip Code:98021-8499
Practice Address - Country:US
Practice Address - Phone:425-219-7355
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-09-16
Last Update Date:2022-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage TherapistGroup - Multi-Specialty