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General NPI Number Information
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NPI Number | 1558091926
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Entity Type | Organization
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Legal Business Name | ASIAN GARDEN SPA LLC
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Dates
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Enumeration Date | 06/16/2022
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Last Update Date | 11/18/2024
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Provider Practice Location Address
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Address Line | 6950 SW 105TH AVE STE 110
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City | BEAVERTON
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State | OR
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Zip | 97008-5441
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Country | US
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Telephone | 503-388-0818
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Fax |
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Provider Business Mailing Address
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Address Line | 6950 SW 105TH AVE STE 110
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City | BEAVERTON
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State | OR
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Zip | 97008-5441
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Country | US
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Telephone | 503-388-0818
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | LU LINDBERG
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Credential |
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Telephone | 503-732-6171
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QP2000X
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Taxonomy Name | Physical Therapy Clinic/Center
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License Number |
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License Number State |
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