Provider Demographics
NPI:1396252177
Name:RISING HEART HEALING
Entity type:Organization
Organization Name:RISING HEART HEALING
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:LICENSED MASSAGE THERAPIST
Authorized Official - Prefix:MS
Authorized Official - First Name:LISA
Authorized Official - Middle Name:L
Authorized Official - Last Name:BURTRAW
Authorized Official - Suffix:
Authorized Official - Credentials:LMT
Authorized Official - Phone:541-349-0202
Mailing Address - Street 1:492 E 13TH AVE STE 208
Mailing Address - Street 2:
Mailing Address - City:EUGENE
Mailing Address - State:OR
Mailing Address - Zip Code:97401-4268
Mailing Address - Country:US
Mailing Address - Phone:541-349-0202
Mailing Address - Fax:541-719-4281
Practice Address - Street 1:492 E 13TH AVE STE 208
Practice Address - Street 2:
Practice Address - City:EUGENE
Practice Address - State:OR
Practice Address - Zip Code:97401-4268
Practice Address - Country:US
Practice Address - Phone:541-349-0202
Practice Address - Fax:541-719-4281
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-01-03
Last Update Date:2018-01-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR5004261QM2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM2500XAmbulatory Health Care FacilitiesClinic/CenterMedical Specialty