Healthcare Provider Details

I. General information

NPI: 1063155257
Provider Name (Legal Business Name): MASSAGE COMFORT AND SPA INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/15/2022
Last Update Date: 07/15/2026
Certification Date: 07/15/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

480 5TH ST
LAKE OSWEGO OR
97034-3079
US

IV. Provider business mailing address

4878 SE POLLARD PL
MILWAUKIE OR
97222-3253
US

V. Phone/Fax

Practice location:
  • Phone: 503-793-8676
  • Fax:
Mailing address:
  • Phone: 503-793-8676
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name: DAVE STEELE
Title or Position: CEO
Credential:
Phone: 503-793-8676