Provider Demographics
NPI:1043523681
Name:HYGEIA MASSAGE AND BODYWORK LLC
Entity type:Organization
Organization Name:HYGEIA MASSAGE AND BODYWORK LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/OPERATOR
Authorized Official - Prefix:
Authorized Official - First Name:JANA
Authorized Official - Middle Name:SUZANNE
Authorized Official - Last Name:LEACH
Authorized Official - Suffix:
Authorized Official - Credentials:LMP
Authorized Official - Phone:360-339-2942
Mailing Address - Street 1:PO BOX 249
Mailing Address - Street 2:
Mailing Address - City:KALAMA
Mailing Address - State:WA
Mailing Address - Zip Code:98625-0300
Mailing Address - Country:US
Mailing Address - Phone:360-339-2942
Mailing Address - Fax:
Practice Address - Street 1:208 CHURCH ST
Practice Address - Street 2:
Practice Address - City:KELSO
Practice Address - State:WA
Practice Address - Zip Code:98626-3409
Practice Address - Country:US
Practice Address - Phone:360-339-2942
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-07-26
Last Update Date:2010-07-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMA 60096769261Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center