MARIAM GEDEVANISHVILI - NPI 1083778104 - Massage Therapist in Kent, WA

Q: What is the provider's specialty?

The provider's specialty is Massage Therapist with taxonomy code 225700000X.

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About Mariam Gedevanishvili NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

MARIAM GEDEVANISHVILI (NPI 1083778104) is an individual massage therapist in Kent, Washington, licensed in Washington (MA60058598) and active in the NPI registry since December 2006.

NPPES Registry Identity

NPI1083778104

Entity TypeIndividualFemale

Primary Taxonomy225700000X

Provider Legal NameMARIAM GEDEVANISHVILI

Location Address10700 SE 208TH ST STE 207Kent, WA 98031-5545

Mailing Address18622 Se 265th StCovington, WA 98042-8421 · (206) 755-1758 · Fax (253) 883-2686

Phone(206) 755-1758

Fax(253) 833-2686

Sole ProprietorYes

Enumeration DateDecember 21, 2006

Last NPPES UpdateJune 11, 2012

✔ NPI 1083778104 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 3

★ Primary SpecialtyMassage TherapistRespiratory, Developmental, Rehabilitative and Restorative Service Providers

Taxonomy Code225700000X

License✔ Licensed in WA · MA60058598

Definition

An individual trained in the manipulation of tissues (as by rubbing, stroking, kneading, or tapping) with the hand or an instrument for remedial or hygienic purposes.

Also ListedNutritionist · Nutrition, EducationTaxonomy 133NN1002X

Also ListedSpecialist/Technologist · Athletic TrainerTaxonomy 2255A2300X

10700 SE 208TH ST STE 207, Kent, WA 98031

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Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include PacificSource Health Plans, Premera Blue Cross Blue Shield of Alaska.Insurance ›