MEDICARE: MASSAGE FOR HEALTH

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	174400000X	Specialist	20399	OR

General Provider Information

NPI Number	:	1962859108
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	MASSAGE FOR HEALTH

Provider Business Mailing Address
First Line	:	17530 SE WALNUT HILL RD.
Second Line	:
City	:	AMITY
State	:	OR
Zip	:	97101
Country	:	US
Telephone Number	:	503-828-7464
Fax Number	:

Provider Business Practice Location Address
First Line	:	17530 SE WALNUT HILL RD
Second Line	:
City	:	AMITY
State	:	OR
Zip	:	97101-2103
Country	:	US
Telephone Number	:	503-828-7464
Fax Number	:

Authorized Official
Title or Position	:	PRESIDENT
Name	:	MISS ASHLEY DIANNE SCHAFFER
Credential	:	LMT
Telephone Number	:	503-828-7464

Provider Enumeration Date	:	05/18/2016
Last Update Date	:	05/18/2016

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Directions to “MASSAGE FOR HEALTH ” Practice Location

Language	Start Address	Practice Location

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