Healthcare Provider Details

I. General information

NPI: 1437063617
Provider Name (Legal Business Name): SOFT TISSUE ENGINEERING LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/02/2026
Last Update Date: 10/02/2026
Certification Date: 10/02/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

809 SE COURT AVE
PENDLETON OR
97801-2344
US

IV. Provider business mailing address

214 SW 8TH ST
PENDLETON OR
97801-1922
US

V. Phone/Fax

Practice location:
  • Phone: 541-612-0603
  • Fax:
Mailing address:
  • Phone: 541-612-0603
  • 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: RYAN KUEMPER
Title or Position: OWNER/OPERATOR
Credential: LMT
Phone: 541-612-0603