Provider Demographics
NPI:1902104201
Name:CTA INTERNATIONAL, INC
Entity Type:Organization
Organization Name:CTA INTERNATIONAL, INC
Other - Org Name:SHIZUKA MASSAGE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:CONNIE
Authorized Official - Middle Name:XY
Authorized Official - Last Name:BEI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:206-650-3331
Mailing Address - Street 1:10226 NE 10TH ST
Mailing Address - Street 2:
Mailing Address - City:BELLEVUE
Mailing Address - State:WA
Mailing Address - Zip Code:98004-4214
Mailing Address - Country:US
Mailing Address - Phone:425-455-3030
Mailing Address - Fax:
Practice Address - Street 1:10226 NE 10TH ST
Practice Address - Street 2:
Practice Address - City:BELLEVUE
Practice Address - State:WA
Practice Address - Zip Code:98004-4214
Practice Address - Country:US
Practice Address - Phone:425-455-3030
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-03-10
Last Update Date:2011-03-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMA 60163010225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage TherapistGroup - Single Specialty