Healthcare Provider Details

I. General information

NPI: 1972978104
Provider Name (Legal Business Name): FIVE BODIES COLLECTIVE LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/14/2015
Last Update Date: 09/02/2025
Certification Date: 02/06/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2485 W 7TH PL STE 1
EUGENE OR
97402-2687
US

IV. Provider business mailing address

PO BOX 40771
EUGENE OR
97404-0133
US

V. Phone/Fax

Practice location:
  • Phone: 541-344-4788
  • Fax: 877-699-5228
Mailing address:
  • Phone: 541-344-4788
  • Fax: 877-699-5228

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code172M00000X
TaxonomyMechanotherapist
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code225700000X
TaxonomyMassage Therapist
License Number
License Number State

VIII. Authorized Official

Name: FOCUS A BURMESTER
Title or Position: OWNER
Credential: LMT
Phone: 541-344-4788