Healthcare Provider Details

I. General information

NPI: 1013780451
Provider Name (Legal Business Name): ALANA GARRETT
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 11/06/2023
Last Update Date: 11/06/2023
Certification Date: 11/06/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

501 NE HOOD AVE STE 205
GRESHAM OR
97030-7325
US

IV. Provider business mailing address

2512 SW 27TH DR
GRESHAM OR
97080-8502
US

V. Phone/Fax

Practice location:
  • Phone: 503-674-7894
  • Fax: 503-674-7899
Mailing address:
  • Phone: 503-341-7340
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225700000X
TaxonomyMassage Therapist
License Number25635
License Number StateOR

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: