Provider Demographics
NPI:1265880181
Name:TWO SUNS MASSAGE THERAPY
Entity type:Organization
Organization Name:TWO SUNS MASSAGE THERAPY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:ASHA
Authorized Official - Middle Name:R
Authorized Official - Last Name:POWELL-STORMBERG
Authorized Official - Suffix:
Authorized Official - Credentials:LMT
Authorized Official - Phone:503-449-5164
Mailing Address - Street 1:9123 SE SAINT HELENS ST
Mailing Address - Street 2:STE 275
Mailing Address - City:CLACKAMAS
Mailing Address - State:OR
Mailing Address - Zip Code:97015-6858
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:9123 SE SAINT HELENS ST
Practice Address - Street 2:STE 275
Practice Address - City:CLACKAMAS
Practice Address - State:OR
Practice Address - Zip Code:97015-6858
Practice Address - Country:US
Practice Address - Phone:503-449-5164
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-06-01
Last Update Date:2016-06-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR15012033972255A2300X
OR17680225700000X
OR13868225700000X
OR17528225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage TherapistGroup - Multi-Specialty
No2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic TrainerGroup - Multi-Specialty