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General NPI Number Information
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NPI Number | 1730804824
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Entity Type | Organization
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Legal Business Name | MARIGOLD MASSAGE AND BODYWORK, LLC
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Dates
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Enumeration Date | 10/11/2022
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Last Update Date | 08/13/2025
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Provider Practice Location Address
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Address Line | 388 STATE ST STE 702
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City | SALEM
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State | OR
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Zip | 97301-4023
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Country | US
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Telephone | 503-856-4999
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Fax |
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Provider Business Mailing Address
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Address Line | 597 W VISTA AVE S
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City | SALEM
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State | OR
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Zip | 97302-5573
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Country | US
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Telephone | 503-856-4999
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Fax |
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Authorized Official
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Title or Position | MASSAGE THERAPIST, OWNER
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Name | MS. HEATHER ELAINE OLSON
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Credential | LMS
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Telephone | 503-856-4999
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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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