Provider Demographics
NPI:1447078787
Name:BRIGHT STAR NATURAL HEALING MASSAGE
Entity type:Organization
Organization Name:BRIGHT STAR NATURAL HEALING MASSAGE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MASSAGE THERAPIST
Authorized Official - Prefix:MS
Authorized Official - First Name:RUIQIN
Authorized Official - Middle Name:
Authorized Official - Last Name:QI
Authorized Official - Suffix:
Authorized Official - Credentials:HEALTHY PROVIDER
Authorized Official - Phone:503-481-1155
Mailing Address - Street 1:1008 NE 63RD ST # 8
Mailing Address - Street 2:
Mailing Address - City:VANCOUVER
Mailing Address - State:WA
Mailing Address - Zip Code:98665-0201
Mailing Address - Country:US
Mailing Address - Phone:503-481-1155
Mailing Address - Fax:
Practice Address - Street 1:3305 MAIN ST STE 100
Practice Address - Street 2:
Practice Address - City:VANCOUVER
Practice Address - State:WA
Practice Address - Zip Code:98663-2234
Practice Address - Country:US
Practice Address - Phone:503-481-1155
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-09-26
Last Update Date:2024-09-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage TherapistGroup - Single Specialty