Provider Demographics
NPI:1679721195
Name:ADARA SALON & SPA
Entity type:Organization
Organization Name:ADARA SALON & SPA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:LINDA
Authorized Official - Middle Name:M
Authorized Official - Last Name:MOHLER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:360-336-2985
Mailing Address - Street 1:1019 CLEVELAND AVENUE
Mailing Address - Street 2:
Mailing Address - City:MOUNT VERNON
Mailing Address - State:WA
Mailing Address - Zip Code:98273
Mailing Address - Country:US
Mailing Address - Phone:360-336-2985
Mailing Address - Fax:360-419-9055
Practice Address - Street 1:1019 CLEVELAND AVENUE
Practice Address - Street 2:
Practice Address - City:MOUNT VERNON
Practice Address - State:WA
Practice Address - Zip Code:98273
Practice Address - Country:US
Practice Address - Phone:360-336-2985
Practice Address - Fax:360-419-9055
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:ADARA SALON & SPA
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2008-09-09
Last Update Date:2008-09-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage TherapistGroup - Multi-Specialty