Provider Demographics
NPI:1225778285
Name:FOCUS FUSION MASSAGE AND WELLNESS LLC
Entity Type:Organization
Organization Name:FOCUS FUSION MASSAGE AND WELLNESS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:LOWELL
Authorized Official - Middle Name:
Authorized Official - Last Name:WELCH
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:503-422-5517
Mailing Address - Street 1:PO BOX 633
Mailing Address - Street 2:
Mailing Address - City:HUBBARD
Mailing Address - State:OR
Mailing Address - Zip Code:97032-0633
Mailing Address - Country:US
Mailing Address - Phone:503-422-5571
Mailing Address - Fax:
Practice Address - Street 1:1755 MOUNT HOOD AVE STE 124
Practice Address - Street 2:
Practice Address - City:WOODBURN
Practice Address - State:OR
Practice Address - Zip Code:97071-9096
Practice Address - Country:US
Practice Address - Phone:503-980-2000
Practice Address - Fax:267-430-5571
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-03-29
Last Update Date:2022-03-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage TherapistGroup - Single Specialty