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General NPI Number Information
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NPI Number | 1386980027
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Entity Type | Organization
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Legal Business Name | OPEN HANDS MASSAGE THERAPY, LLC
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Dates
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Enumeration Date | 12/28/2012
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Last Update Date | 12/28/2012
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Provider Practice Location Address
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Address Line | 2008 WILLAMETTE FALLS DR STE 200A
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City | WEST LINN
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State | OR
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Zip | 97068-4658
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Country | US
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Telephone | 503-724-0550
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Fax | 503-723-5112
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Provider Business Mailing Address
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Address Line | PO BOX 2661
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City | WILSONVILLE
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State | OR
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Zip | 97070-2661
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Country | US
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Telephone | 503-724-0550
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Fax | 503-723-5112
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Authorized Official
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Title or Position | OWNER
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Name | CATHERINE B WEAVER
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Credential | LMT
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Telephone | 503-724-0550
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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 | 18010
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License Number State | OR
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