MEDICARE: BODY LOVE WELLNESS 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	171100000X	Acupuncturist

General Provider Information

NPI Number	:	1922864255
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	BODY LOVE WELLNESS LLC

Provider Business Mailing Address
First Line	:	1616 SE ANKENY ST
Second Line	:
City	:	PORTLAND
State	:	OR
Zip	:	97214-1448
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	1616 SE ANKENY ST
Second Line	:
City	:	PORTLAND
State	:	OR
Zip	:	97214-1448
Country	:	US
Telephone Number	:	971-279-8597
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	ALYSSA SCHAFFER
Credential	:	LAC
Telephone Number	:	971-279-8597

Provider Enumeration Date	:	02/23/2024
Last Update Date	:	01/24/2026

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Directions to “BODY LOVE WELLNESS LLC ” Practice Location

Language	Start Address	Practice Location

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