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General NPI Number Information
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NPI Number | 1841184124
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Entity Type | Organization
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Legal Business Name | BIG HEART HOME MASSAGE AND HEALING ARTS LLC
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Dates
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Enumeration Date | 06/03/2025
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Last Update Date | 06/03/2025
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Provider Practice Location Address
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Address Line | 1975 NW 167TH PL STE 100-46
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City | BEAVERTON
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State | OR
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Zip | 97006-4908
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Country | US
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Telephone | 971-217-6420
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Fax | 971-423-0886
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Provider Business Mailing Address
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Address Line | 6405 SW PROSPECT CT
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City | ALOHA
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State | OR
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Zip | 97078-4318
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Country | US
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Telephone | 480-227-2486
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | MALLORY GRAVES
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Credential | LMT
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Telephone | 480-227-2486
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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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