Healthcare Provider Details

I. General information

NPI: 1902464902
Provider Name (Legal Business Name): OMM, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/04/2019
Last Update Date: 12/05/2025
Certification Date: 12/05/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1445 WILLAMETTE ST STE 3
EUGENE OR
97401-4087
US

IV. Provider business mailing address

1445 WILLAMETTE ST STE 3
EUGENE OR
97401-4087
US

V. Phone/Fax

Practice location:
  • Phone: 541-286-5455
  • Fax: 844-918-0396
Mailing address:
  • Phone: 541-286-5455
  • Fax: 844-918-0396

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225700000X
TaxonomyMassage Therapist
License Number
License Number State

VIII. Authorized Official

Name: LOREN MICHAEL FRIEDMAN
Title or Position: MANAGER
Credential: LMT
Phone: 541-286-5455