Provider Demographics
NPI:1366645210
Name:KENT MASSAGE PRO
Entity type:Organization
Organization Name:KENT MASSAGE PRO
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:A
Authorized Official - Middle Name:
Authorized Official - Last Name:ZOHRABIAN
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:253-520-4055
Mailing Address - Street 1:922 CENTRAL AVE N
Mailing Address - Street 2:
Mailing Address - City:KENT
Mailing Address - State:WA
Mailing Address - Zip Code:98032-3048
Mailing Address - Country:US
Mailing Address - Phone:253-520-4055
Mailing Address - Fax:253-520-1994
Practice Address - Street 1:922 CENTRAL AVE N
Practice Address - Street 2:
Practice Address - City:KENT
Practice Address - State:WA
Practice Address - Zip Code:98032-3048
Practice Address - Country:US
Practice Address - Phone:253-520-4055
Practice Address - Fax:253-520-1994
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-06-07
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage TherapistGroup - Single Specialty