Provider Demographics
NPI:1750743654
Name:HOLISTIC MASSAGE OF HOOD RIVER
Entity type:Organization
Organization Name:HOLISTIC MASSAGE OF HOOD RIVER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:JENNIFER
Authorized Official - Middle Name:
Authorized Official - Last Name:HARVEY-SMITH
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:541-490-1444
Mailing Address - Street 1:PO BOX 571
Mailing Address - Street 2:
Mailing Address - City:HOOD RIVER
Mailing Address - State:OR
Mailing Address - Zip Code:97031-0018
Mailing Address - Country:US
Mailing Address - Phone:541-490-1444
Mailing Address - Fax:
Practice Address - Street 1:104 5TH ST
Practice Address - Street 2:
Practice Address - City:HOOD RIVER
Practice Address - State:OR
Practice Address - Zip Code:97031-2058
Practice Address - Country:US
Practice Address - Phone:541-490-1444
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-03-22
Last Update Date:2016-03-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage TherapistGroup - Multi-Specialty