Provider Demographics
NPI:1407378474
Name:HEALING SPIRIT MASSAGE AND HEALTH SPA, LLC
Entity Type:Organization
Organization Name:HEALING SPIRIT MASSAGE AND HEALTH SPA, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/OPERATOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:TAMERA
Authorized Official - Middle Name:L
Authorized Official - Last Name:VEEK
Authorized Official - Suffix:
Authorized Official - Credentials:LMT
Authorized Official - Phone:541-382-5050
Mailing Address - Street 1:1404 NE 3RD ST STE 6
Mailing Address - Street 2:
Mailing Address - City:BEND
Mailing Address - State:OR
Mailing Address - Zip Code:97701-4278
Mailing Address - Country:US
Mailing Address - Phone:541-382-5050
Mailing Address - Fax:
Practice Address - Street 1:1404 NE 3RD ST STE 6
Practice Address - Street 2:
Practice Address - City:BEND
Practice Address - State:OR
Practice Address - Zip Code:97701-4278
Practice Address - Country:US
Practice Address - Phone:541-382-5050
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-07-12
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR2089225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage TherapistGroup - Single Specialty