Healthcare Provider Details

I. General information

NPI: 1689592149
Provider Name (Legal Business Name): GABRIEL LOUIS OLSEN-MARTINEZ
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/09/2026
Last Update Date: 07/09/2026
Certification Date: 07/09/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1274 W 7TH AVE
EUGENE OR
97402-4523
US

IV. Provider business mailing address

947 TIARA ST
EUGENE OR
97405-6309
US

V. Phone/Fax

Practice location:
  • Phone: 541-762-1755
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225700000X
TaxonomyMassage Therapist
License Number29664
License Number StateOR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: