Provider Demographics
NPI:1669292207
Name:WELLNESS ON WHEELS LLC
Entity type:Organization
Organization Name:WELLNESS ON WHEELS LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:JULIE
Authorized Official - Middle Name:
Authorized Official - Last Name:TONELLI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:503-752-0917
Mailing Address - Street 1:8921 SW 35TH AVE
Mailing Address - Street 2:
Mailing Address - City:PORTLAND
Mailing Address - State:OR
Mailing Address - Zip Code:97219-3807
Mailing Address - Country:US
Mailing Address - Phone:503-752-0917
Mailing Address - Fax:
Practice Address - Street 1:3530 SW MULTNOMAH BLVD
Practice Address - Street 2:
Practice Address - City:PORTLAND
Practice Address - State:OR
Practice Address - Zip Code:97219-3786
Practice Address - Country:US
Practice Address - Phone:503-752-0917
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-10-16
Last Update Date:2024-10-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage TherapistGroup - Single Specialty