Hosea Immanuel I, MASSAGE THERAPIST
Individual provider Active NPI Massage Therapist · Milton, WA
NPI 1578897500 · NPPES record last updated Sep 23, 2009
Key facts
- NPI
- 1578897500
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Massage Therapist 225700000X
- License
- MA 60036633 (WA)
- Practice address
- 624 Meridian E Ste a
Milton, WA 98354-9328 - Phone
- (253) 952-2001
- NPI assigned
- Sep 23, 2009
- Sex
- Male
- Sole proprietor
- Yes
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| MA 60036633 | WA | MD | Massage Therapist |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Massage Therapist | 225700000X | MA 60036633 | WA | Yes |
Addresses
Primary practice location
624 Meridian E Ste a
Milton, WA 98354-9328
Mailing address
624 Meridian E Ste a
Milton, WA 98354-9328
Phone (253) 952-2001
Other providers in Milton, WA
- Ha T Hoang
- Sierra Hodge-Finch
- Shanta Rene Horton
- Jungsun Huh
- Iiris
- Integrity Home Care LLC
- Melody Jackson
- V'Nyssa James
- Alexis Jean Baptiste
- Hannah Jorgenson
All providers in Milton, WA · Massage Therapist in Washington
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Sep 23, 2009. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.