Provider Demographics
NPI:1568627446
Name:ROSE SPRINGS, LLC
Entity Type:Organization
Organization Name:ROSE SPRINGS, LLC
Other - Org Name:ROSE SPRINGS MASSAGE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:MEMBER
Authorized Official - Prefix:
Authorized Official - First Name:DENNIS
Authorized Official - Middle Name:I
Authorized Official - Last Name:SMITH
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:503-693-9101
Mailing Address - Street 1:5215 NE ELAM YOUNG PKWY
Mailing Address - Street 2:STE A
Mailing Address - City:HILLSBORO
Mailing Address - State:OR
Mailing Address - Zip Code:97124-6498
Mailing Address - Country:US
Mailing Address - Phone:503-693-9101
Mailing Address - Fax:503-693-9123
Practice Address - Street 1:5215 NE ELAM YOUNG PKWY
Practice Address - Street 2:STE A
Practice Address - City:HILLSBORO
Practice Address - State:OR
Practice Address - Zip Code:97124-6498
Practice Address - Country:US
Practice Address - Phone:503-693-9101
Practice Address - Fax:503-693-9123
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-07-21
Last Update Date:2008-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR6668225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage TherapistGroup - Single Specialty