MEDICARE: HEALING HANDSMASSAGE AND BODYWORK

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	302R00000X	Health Maintenance Organization	7971	OR

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	1649483710	OTHER	OR	CHP

General Provider Information

NPI Number	:	1104223957
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	HEALING HANDSMASSAGE AND BODYWORK

Provider Business Mailing Address
First Line	:	1511 HESS CREEK CT
Second Line	:
City	:	NEWBERG
State	:	OR
Zip	:	97132-9579
Country	:	US
Telephone Number	:	503-997-6847
Fax Number	:	503-538-9679

Provider Business Practice Location Address
First Line	:	1511 HESS CREEK CT
Second Line	:
City	:	NEWBERG
State	:	OR
Zip	:	97132-9579
Country	:	US
Telephone Number	:	503-997-6847
Fax Number	:	503-538-9679

Authorized Official
Title or Position	:	OWNER
Name	:	JEANNIA (WILLOW) ANN MUHR
Credential	:	LMT
Telephone Number	:	503-997-6847

Provider Enumeration Date	:	11/21/2014
Last Update Date	:	11/21/2014

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Directions to “HEALING HANDSMASSAGE AND BODYWORK ” Practice Location

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