Healthcare Provider Details

I. General information

NPI: 1952109100
Provider Name (Legal Business Name): CASSIDY MORSE
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/04/2025
Last Update Date: 01/21/2026
Certification Date: 01/21/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1662 SW MAWRCREST AVE
GRESHAM OR
97080-5756
US

IV. Provider business mailing address

1662 SW MAWRCREST AVE
GRESHAM OR
97080-5756
US

V. Phone/Fax

Practice location:
  • Phone: 971-201-5139
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225700000X
TaxonomyMassage Therapist
License Number28749
License Number StateOR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: