Provider Demographics
NPI:1649785932
Name:FORWARD MASSAGE AND WELLNESS LLC
Entity type:Organization
Organization Name:FORWARD MASSAGE AND WELLNESS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:JOSEPH
Authorized Official - Last Name:RITTER
Authorized Official - Suffix:
Authorized Official - Credentials:LMT
Authorized Official - Phone:206-775-3649
Mailing Address - Street 1:14217 EVANSTON AVE N
Mailing Address - Street 2:
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98133-6856
Mailing Address - Country:US
Mailing Address - Phone:206-226-8622
Mailing Address - Fax:
Practice Address - Street 1:14217 EVANSTON AVE N
Practice Address - Street 2:
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98133-6856
Practice Address - Country:US
Practice Address - Phone:206-226-8622
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-12-07
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMA60776905225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage TherapistGroup - Single Specialty