Provider Demographics
NPI:1053166520
Name:CENTRAL THERAPEUTIC MASSAGE
Entity type:Organization
Organization Name:CENTRAL THERAPEUTIC MASSAGE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:ROXANE
Authorized Official - Middle Name:
Authorized Official - Last Name:GELLER
Authorized Official - Suffix:
Authorized Official - Credentials:LAC OR EAMP
Authorized Official - Phone:206-409-0566
Mailing Address - Street 1:2004 E UNION ST
Mailing Address - Street 2:
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98122-2836
Mailing Address - Country:US
Mailing Address - Phone:206-329-2060
Mailing Address - Fax:206-219-0598
Practice Address - Street 1:2004 E UNION ST
Practice Address - Street 2:
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98122-2836
Practice Address - Country:US
Practice Address - Phone:206-329-2060
Practice Address - Fax:206-219-0598
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-04-18
Last Update Date:2024-04-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage TherapistGroup - Single Specialty