Provider Demographics
NPI:1922799600
Name:HEY SISTER SPA P-LLC
Entity Type:Organization
Organization Name:HEY SISTER SPA P-LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEDICAL DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:RENEE
Authorized Official - Middle Name:
Authorized Official - Last Name:STORM
Authorized Official - Suffix:
Authorized Official - Credentials:APRN
Authorized Official - Phone:503-467-6589
Mailing Address - Street 1:1410 NW KEARNEY ST APT 921
Mailing Address - Street 2:
Mailing Address - City:PORTLAND
Mailing Address - State:OR
Mailing Address - Zip Code:97209-2770
Mailing Address - Country:US
Mailing Address - Phone:503-467-6589
Mailing Address - Fax:571-368-5192
Practice Address - Street 1:1309 NE 134TH ST STE B
Practice Address - Street 2:
Practice Address - City:VANCOUVER
Practice Address - State:WA
Practice Address - Zip Code:98685-2704
Practice Address - Country:US
Practice Address - Phone:503-467-6589
Practice Address - Fax:571-368-5192
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-05-15
Last Update Date:2023-12-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center