Provider Demographics
NPI:1598062242
Name:CARCON
Entity Type:Organization
Organization Name:CARCON
Other - Org Name:MASSAGE ENVY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:STEVE
Authorized Official - Middle Name:J
Authorized Official - Last Name:NORRIS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:503-625-0100
Mailing Address - Street 1:16078 SW TUALATIN SHERWOOD RD
Mailing Address - Street 2:
Mailing Address - City:SHERWOOD
Mailing Address - State:OR
Mailing Address - Zip Code:97140-8522
Mailing Address - Country:US
Mailing Address - Phone:503-625-0100
Mailing Address - Fax:503-625-0301
Practice Address - Street 1:16078 SW TUALATIN SHERWOOD RD
Practice Address - Street 2:
Practice Address - City:SHERWOOD
Practice Address - State:OR
Practice Address - Zip Code:97140-8522
Practice Address - Country:US
Practice Address - Phone:503-625-0100
Practice Address - Fax:503-625-0301
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-02-15
Last Update Date:2011-02-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage TherapistGroup - Multi-Specialty