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General NPI Number Information
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NPI Number | 1790298438
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Entity Type | Organization
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Legal Business Name | THE GROUNDING TOUCH
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Dates
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Enumeration Date | 11/15/2017
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Last Update Date | 11/15/2017
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Provider Practice Location Address
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Address Line | 2025 SE JEFFERSON ST
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City | MILWAUKIE
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State | OR
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Zip | 97222-7605
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Country | US
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Telephone | 971-409-9241
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Fax |
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Provider Business Mailing Address
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Address Line | 17595 KIRKWOOD ST
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City | GLADSTONE
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State | OR
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Zip | 97027-1402
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Country | US
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Telephone | 971-409-9241
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Fax |
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Authorized Official
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Title or Position | MASSAGE THERAPIST
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Name | AMY E SCOTT
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Credential | LMT
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Telephone | 971-409-9241
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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 | 14720
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License Number State | OR
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