Provider Demographics
NPI:1144879453
Name:ROSE ROCK BODYWORK
Entity type:Organization
Organization Name:ROSE ROCK BODYWORK
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:JESSICA
Authorized Official - Middle Name:RENEE
Authorized Official - Last Name:SANCHEZ-HARPER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:503-488-0761
Mailing Address - Street 1:2200 BROADWAY ST STE C
Mailing Address - Street 2:
Mailing Address - City:VANCOUVER
Mailing Address - State:WA
Mailing Address - Zip Code:98663-3255
Mailing Address - Country:US
Mailing Address - Phone:360-890-9794
Mailing Address - Fax:136-078-5238
Practice Address - Street 1:2200 BROADWAY ST STE C
Practice Address - Street 2:
Practice Address - City:VANCOUVER
Practice Address - State:WA
Practice Address - Zip Code:98663-3255
Practice Address - Country:US
Practice Address - Phone:360-890-9794
Practice Address - Fax:136-078-5238
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-09-09
Last Update Date:2019-09-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage TherapistGroup - Single Specialty