Provider Demographics
NPI:1629358320
Name:ALI OGLE, LMT
Entity Type:Organization
Organization Name:ALI OGLE, LMT
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER, MASSAGE THERAPIST
Authorized Official - Prefix:MISS
Authorized Official - First Name:ALI
Authorized Official - Middle Name:
Authorized Official - Last Name:OGLE
Authorized Official - Suffix:
Authorized Official - Credentials:LMT
Authorized Official - Phone:503-607-0018
Mailing Address - Street 1:2008 WILLAMETTE FALLS DR
Mailing Address - Street 2:STE 200A
Mailing Address - City:WEST LINN
Mailing Address - State:OR
Mailing Address - Zip Code:97068-4658
Mailing Address - Country:US
Mailing Address - Phone:503-607-0018
Mailing Address - Fax:503-723-5112
Practice Address - Street 1:2008 WILLAMETTE FALLS DR
Practice Address - Street 2:STE 200A
Practice Address - City:WEST LINN
Practice Address - State:OR
Practice Address - Zip Code:97068-4658
Practice Address - Country:US
Practice Address - Phone:503-607-0018
Practice Address - Fax:503-723-5112
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:SACHI WELLNESS CENTER
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2011-08-25
Last Update Date:2011-08-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR11485174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Multi-Specialty