Healthcare Provider Details

I. General information

NPI: 1881378099
Provider Name (Legal Business Name): WOVEN HAND HEALTH LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/09/2023
Last Update Date: 06/09/2023
Certification Date: 06/02/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

513 NE SCHUYLER ST OFFICE 3
PORTLAND OR
97212
US

IV. Provider business mailing address

625 SE 30TH AVE APT D
PORTLAND OR
97214-3195
US

V. Phone/Fax

Practice location:
  • Phone: 631-561-9468
  • Fax:
Mailing address:
  • Phone: 631-561-9468
  • 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: MICHAEL GUIDA
Title or Position: OWNER & OPERATOR
Credential: LMT
Phone: 631-561-9468