1003237355 NPI number — ROLFING WORKS LLC

Table of content: (NPI 1003237355)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1003237355 NPI number — ROLFING WORKS LLC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
ROLFING WORKS LLC
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1003237355
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
01/03/2014
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
1110 LARRABEE AVE
Provider Second Line Business Mailing Address:
SUITE 204
Provider Business Mailing Address City Name:
BELLINGHAM
Provider Business Mailing Address State Name:
WA
Provider Business Mailing Address Postal Code:
98225-7302
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
360-671-0546
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
1110 LARRABEE AVE
Provider Second Line Business Practice Location Address:
SUITE 204
Provider Business Practice Location Address City Name:
BELLINGHAM
Provider Business Practice Location Address State Name:
WA
Provider Business Practice Location Address Postal Code:
98225-7302
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
360-671-0546
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
01/03/2014

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
STOLZOFF
Authorized Official First Name:
RUSSELL
Authorized Official Middle Name:
Authorized Official Title or Position:
OWNER/CERTIFIED ADVANCED ROLFER
Authorized Official Telephone Number:
360-671-0546

Provider Taxonomy Codes

  • Taxonomy code: 225700000X , with the licence number:  MA00014127 , registered in the state of WA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .
  • Taxonomy code: 225700000X , with the licence number: MA60423223 , registered in the state of WA ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .

Other Provider's Identifiers (legacy, non-NPI)