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General NPI Number Information
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NPI Number | 1962859108
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Entity Type | Organization
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Legal Business Name | MASSAGE FOR HEALTH
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Dates
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Enumeration Date | 05/18/2016
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Last Update Date | 05/18/2016
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Provider Practice Location Address
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Address Line | 17530 SE WALNUT HILL RD
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City | AMITY
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State | OR
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Zip | 97101-2103
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Country | US
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Telephone | 503-828-7464
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Fax |
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Provider Business Mailing Address
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Address Line | 17530 SE WALNUT HILL RD.
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City | AMITY
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State | OR
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Zip | 97101
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Country | US
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Telephone | 503-828-7464
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | MISS ASHLEY DIANNE SCHAFFER
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Credential | LMT
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Telephone | 503-828-7464
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 174400000X
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Taxonomy Name | Specialist
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License Number | 20399
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License Number State | OR
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