Provider Demographics
NPI:1518603133
Name:MASSAGE SPOT PDX
Entity Type:Organization
Organization Name:MASSAGE SPOT PDX
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/LICENSED MASSAGE THERAPIST
Authorized Official - Prefix:
Authorized Official - First Name:AARON
Authorized Official - Middle Name:RAY
Authorized Official - Last Name:HILL
Authorized Official - Suffix:
Authorized Official - Credentials:LMT
Authorized Official - Phone:971-226-2664
Mailing Address - Street 1:2256 N ALBINA AVE STE 173
Mailing Address - Street 2:
Mailing Address - City:PORTLAND
Mailing Address - State:OR
Mailing Address - Zip Code:97227-1775
Mailing Address - Country:US
Mailing Address - Phone:971-258-2279
Mailing Address - Fax:
Practice Address - Street 1:2256 N ALBINA AVE STE 173
Practice Address - Street 2:
Practice Address - City:PORTLAND
Practice Address - State:OR
Practice Address - Zip Code:97227-1775
Practice Address - Country:US
Practice Address - Phone:971-258-2279
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-05-06
Last Update Date:2022-05-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage TherapistGroup - Single Specialty