MEDICARE: PBF ENTERPRISES, INC.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	225700000X	Massage Therapist	12813	OR

General Provider Information

NPI Number	:	1700910395
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	PBF ENTERPRISES, INC.

Provider Business Mailing Address
First Line	:	1541 COLUMBIA BLVD
Second Line	:
City	:	SAINT HELENS
State	:	OR
Zip	:	97051-6212
Country	:	US
Telephone Number	:	503-397-0429
Fax Number	:

Provider Business Practice Location Address
First Line	:	1541 COLUMBIA BLVD
Second Line	:
City	:	SAINT HELENS
State	:	OR
Zip	:	97051-6212
Country	:	US
Telephone Number	:	503-397-0429
Fax Number	:

Authorized Official
Title or Position	:	PRESIDENT
Name	:	MS. PRATITI FULLERTON
Credential	:	LMT
Telephone Number	:	503-397-0429

Provider Enumeration Date	:	03/15/2007
Last Update Date	:	08/22/2020

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Directions to “PBF ENTERPRISES, INC. ” Practice Location

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