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General NPI Number Information
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NPI Number | 1104223957
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Entity Type | Organization
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Legal Business Name | HEALING HANDSMASSAGE AND BODYWORK
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Dates
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Enumeration Date | 11/21/2014
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Last Update Date | 11/21/2014
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Provider Practice Location Address
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Address Line | 1511 HESS CREEK CT
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City | NEWBERG
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State | OR
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Zip | 97132-9579
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Country | US
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Telephone | 503-997-6847
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Fax | 503-538-9679
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Provider Business Mailing Address
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Address Line | 1511 HESS CREEK CT
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City | NEWBERG
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State | OR
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Zip | 97132-9579
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Country | US
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Telephone | 503-997-6847
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Fax | 503-538-9679
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Authorized Official
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Title or Position | OWNER
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Name | JEANNIA (WILLOW) ANN MUHR
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Credential | LMT
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Telephone | 503-997-6847
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 302R00000X
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Taxonomy Name | Health Maintenance Organization
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License Number | 7971
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License Number State | OR
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