Provider Demographics
NPI:1720350044
Name:MASSAGE SOLACE LLC
Entity Type:Organization
Organization Name:MASSAGE SOLACE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MASSAGE THERAPIST
Authorized Official - Prefix:MRS
Authorized Official - First Name:SARAH
Authorized Official - Middle Name:
Authorized Official - Last Name:SCHLAMP
Authorized Official - Suffix:
Authorized Official - Credentials:LMT
Authorized Official - Phone:503-756-9365
Mailing Address - Street 1:19142 MOLALLA AVE STE A
Mailing Address - Street 2:
Mailing Address - City:OREGON CITY
Mailing Address - State:OR
Mailing Address - Zip Code:97045-7166
Mailing Address - Country:US
Mailing Address - Phone:503-756-9365
Mailing Address - Fax:
Practice Address - Street 1:19142 MOLALLA AVE STE A
Practice Address - Street 2:
Practice Address - City:OREGON CITY
Practice Address - State:OR
Practice Address - Zip Code:97045-7166
Practice Address - Country:US
Practice Address - Phone:503-756-9365
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-02-01
Last Update Date:2012-02-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QH0100XAmbulatory Health Care FacilitiesClinic/CenterHealth Service
Provider Identifiers
StateIdentifier IDID TypeIssuer
OR1861647299OtherNPI TYPE 1