Provider Demographics
NPI:1033667126
Name:MICRO WELLNESS GROUP, INC
Entity Type:Organization
Organization Name:MICRO WELLNESS GROUP, INC
Other - Org Name:YOGA OMAZING
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:
Authorized Official - Last Name:ROTEIK
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:503-430-1759
Mailing Address - Street 1:1849 NW 188TH AVE STE 200
Mailing Address - Street 2:
Mailing Address - City:HILLSBORO
Mailing Address - State:OR
Mailing Address - Zip Code:97006-6485
Mailing Address - Country:US
Mailing Address - Phone:503-430-1759
Mailing Address - Fax:
Practice Address - Street 1:1849 NW 188TH AVE STE 200
Practice Address - Street 2:
Practice Address - City:HILLSBORO
Practice Address - State:OR
Practice Address - Zip Code:97006-6485
Practice Address - Country:US
Practice Address - Phone:503-430-1759
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-09-16
Last Update Date:2016-09-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ORFA00080225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage TherapistGroup - Single Specialty