Healthcare Provider Details

I. General information

NPI: 1487343299
Provider Name (Legal Business Name): IKIGAI WELLNESS LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/08/2023
Last Update Date: 01/01/2026
Certification Date: 01/01/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9600 SW OAK ST STE 410
TIGARD OR
97223-6581
US

IV. Provider business mailing address

9600 SW OAK ST STE 410
TIGARD OR
97223-6581
US

V. Phone/Fax

Practice location:
  • Phone: 503-308-8676
  • Fax: 503-821-7881
Mailing address:
  • Phone: 503-308-8676
  • Fax: 503-821-7881

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code171100000X
TaxonomyAcupuncturist
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code225700000X
TaxonomyMassage Therapist
License Number
License Number State

VIII. Authorized Official

Name: MRS. AMY NICOLE HOMER-BROWN
Title or Position: OWNER & ACUPUNCTURIST
Credential: MBBS, MSOM, LAC
Phone: 503-308-8676