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General NPI Number Information
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NPI Number | 1063155257
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Entity Type | Organization
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Legal Business Name | MASSAGE COMFORT AND SPA INC
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Dates
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Enumeration Date | 04/15/2022
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Last Update Date | 09/14/2024
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Provider Practice Location Address
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Address Line | 480 5TH ST
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City | LAKE OSWEGO
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State | OR
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Zip | 97034-3079
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Country | US
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Telephone | 503-793-8676
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Fax |
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Provider Business Mailing Address
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Address Line | 4878 SE POLLARD PL
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City | MILWAUKIE
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State | OR
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Zip | 97222-3253
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Country | US
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Telephone | 503-793-8676
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Fax |
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Authorized Official
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Title or Position | CEO
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Name | DAVE STEELE
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Credential |
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Telephone | 503-793-8676
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 111N00000X
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Taxonomy Name | Chiropractor
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License Number |
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License Number State |
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Taxonomy #2
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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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