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General NPI Number Information
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NPI Number | 1790517217
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Entity Type | Organization
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Legal Business Name | STILLNESS AND MOVEMENT LLC
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Dates
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Enumeration Date | 08/14/2024
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Last Update Date | 08/14/2024
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Provider Practice Location Address
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Address Line | 3863 SW HALL BLVD STE B
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City | BEAVERTON
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State | OR
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Zip | 97005-2042
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Country | US
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Telephone | 503-208-4638
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Fax |
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Provider Business Mailing Address
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Address Line | 3830 NW CHEMULT PL
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City | PORTLAND
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State | OR
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Zip | 97229-3157
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | STEVEN THAMMASOUK
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Credential | DACM, LAC
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Telephone | 503-208-4638
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261Q00000X
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Taxonomy Name | Clinic/Center
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License Number |
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License Number State |
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