Healthcare Provider Details

I. General information

NPI: 1376466151
Provider Name (Legal Business Name): OCEAN, EARTH & STONE MASSAGE LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/30/2026
Last Update Date: 07/30/2026
Certification Date: 07/30/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3523 HIGHWAY 101 N
SEASIDE OR
97138-4319
US

IV. Provider business mailing address

PO BOX 1175
WARRENTON OR
97146-1175
US

V. Phone/Fax

Practice location:
  • Phone: 971-445-6140
  • Fax:
Mailing address:
  • Phone:
  • 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: MELISSA SPIVEY
Title or Position: OWNER/OPERATOR
Credential: LMT
Phone: 971-445-6140