=====================================================
General NPI Number Information
=====================================================
NPI Number | 1073467957
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | DAHLIA WELLNESS LLC
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 02/25/2026
-----------------------------------------------------
Last Update Date | 02/25/2026
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 803 GRAND BLVD STE A2
-----------------------------------------------------
City | VANCOUVER
-----------------------------------------------------
State | WA
-----------------------------------------------------
Zip | 98661-4823
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 503-839-9889
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 803 GRAND BLVD STE A2
-----------------------------------------------------
City | VANCOUVER
-----------------------------------------------------
State | WA
-----------------------------------------------------
Zip | 98661-4823
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 503-839-9889
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | OWNER
-----------------------------------------------------
Name | SARA BLACK
-----------------------------------------------------
Credential | LMT
-----------------------------------------------------
Telephone | 503-839-9889
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 225700000X
-----------------------------------------------------
Taxonomy Name | Massage Therapist
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------