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General NPI Number Information
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NPI Number | 1104604727
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Entity Type | Organization
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Legal Business Name | KNOTS AND HANDS
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Dates
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Enumeration Date | 09/15/2023
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Last Update Date | 09/15/2023
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Provider Practice Location Address
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Address Line | 480 CLEARWATER LANE
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City | LAKE ARROWHEAD
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State | CA
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Zip | 92352
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Country | US
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Telephone | 310-905-0613
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Fax | 909-494-7597
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Provider Business Mailing Address
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Address Line | 1411 NW QUIMBY ST APT 417
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City | PORTLAND
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State | OR
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Zip | 97209-4090
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Country | US
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Telephone | 310-905-0613
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Fax | 909-494-7597
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Authorized Official
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Title or Position | LEAD LICENSED MASSAGE THERAPIST
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Name | CAMERON OXENHAM
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Credential | LMT
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Telephone | 310-905-0613
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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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