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General NPI Number Information
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NPI Number | 1063121085
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Entity Type | Organization
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Legal Business Name | HIMALAYAN BODY WORKS, LLC
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Dates
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Enumeration Date | 11/17/2022
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Last Update Date | 02/04/2025
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Provider Practice Location Address
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Address Line | 2367 STATE ST STE 100
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City | SALEM
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State | OR
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Zip | 97301-4505
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Country | US
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Telephone | 503-568-2854
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Fax | 971-600-9079
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Provider Business Mailing Address
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Address Line | 2270 CHAPMAN HILL DR NW
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City | SALEM
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State | OR
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Zip | 97304-2541
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Country | US
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Telephone | 503-877-2805
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Fax | 971-600-9079
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Authorized Official
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Title or Position | MEMBER
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Name | BLAKE DUNHAM
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Credential | LMT
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Telephone | 971-375-6950
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 225700000X
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Taxonomy Name | Massage Therapist
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License Number |
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License Number State |
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