MEDICARE: GRAY HEALING ARTS LLC

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	225700000X	Massage Therapist

General Provider Information

NPI Number	:	1801693684
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	GRAY HEALING ARTS LLC

Provider Business Mailing Address
First Line	:	151 N KILLINGSWORTH ST APT 213
Second Line	:
City	:	PORTLAND
State	:	OR
Zip	:	97217-2472
Country	:	US
Telephone Number	:	208-971-1688
Fax Number	:

Provider Business Practice Location Address
First Line	:	7238 N BURLINGTON AVE
Second Line	:
City	:	PORTLAND
State	:	OR
Zip	:	97203-4817
Country	:	US
Telephone Number	:	208-971-1688
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	SKYE GRAY
Credential	:	LMT
Telephone Number	:	208-971-1688

Provider Enumeration Date	:	02/27/2025
Last Update Date	:	02/27/2025

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Directions to “GRAY HEALING ARTS LLC ” Practice Location

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