Provider Demographics
NPI:1144197534
Name:SAGE & SOUL MASSAGE PLLC
Entity type:Organization
Organization Name:SAGE & SOUL MASSAGE PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/LMT
Authorized Official - Prefix:
Authorized Official - First Name:AMANDA
Authorized Official - Middle Name:KAY
Authorized Official - Last Name:SILVERMAN
Authorized Official - Suffix:
Authorized Official - Credentials:MA00022339
Authorized Official - Phone:206-888-8348
Mailing Address - Street 1:3850 KLAHANIE DR SE APT 23-205
Mailing Address - Street 2:
Mailing Address - City:SAMMAMISH
Mailing Address - State:WA
Mailing Address - Zip Code:98029-7799
Mailing Address - Country:US
Mailing Address - Phone:206-883-8348
Mailing Address - Fax:
Practice Address - Street 1:301 W NORTH BEND WAY STE 107
Practice Address - Street 2:
Practice Address - City:NORTH BEND
Practice Address - State:WA
Practice Address - Zip Code:98045-8163
Practice Address - Country:US
Practice Address - Phone:206-883-8348
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-10-20
Last Update Date:2025-10-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage TherapistGroup - Single Specialty