Healthcare Provider Details
I. General information
NPI: 1689086670
Provider Name (Legal Business Name): A BETTER WAY MASSAGE, LLC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 05/24/2014
Last Update Date: 01/09/2017
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
500 N COLUMBIA RIVER HWY STE 410
SAINT HELENS OR
97051-1299
US
IV. Provider business mailing address
500 N COLUMBIA RIVER HWY STE 410
SAINT HELENS OR
97051-1299
US
V. Phone/Fax
- Phone: 971-409-5669
- Fax:
- Phone: 503-410-5623
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 111N00000X |
| Taxonomy | Chiropractor |
| License Number | |
| License Number State | |
| # 2 | |
| Primary Taxonomy | N |
| Taxonomy Code | 225700000X |
| Taxonomy | Massage Therapist |
| License Number | 15194 |
| License Number State | OR |
VIII. Authorized Official
Name:
CRYSTAL
FARLOW
Title or Position: OWNER
Credential: LMT
Phone: 503-410-5623