Provider Demographics
NPI:1881478428
Name:GENTLE CARE MASSAGE & SPA
Entity type:Organization
Organization Name:GENTLE CARE MASSAGE & SPA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:YAN
Authorized Official - Middle Name:
Authorized Official - Last Name:LI
Authorized Official - Suffix:
Authorized Official - Credentials:MASSAGE THRAPIST
Authorized Official - Phone:503-267-8903
Mailing Address - Street 1:5207 COVENTRY CT
Mailing Address - Street 2:
Mailing Address - City:LAKE OSWEGO
Mailing Address - State:OR
Mailing Address - Zip Code:97035-8700
Mailing Address - Country:US
Mailing Address - Phone:503-267-8903
Mailing Address - Fax:503-747-3365
Practice Address - Street 1:15975 SW 72ND AVE
Practice Address - Street 2:
Practice Address - City:TIGARD
Practice Address - State:OR
Practice Address - Zip Code:97224-7960
Practice Address - Country:US
Practice Address - Phone:503-267-8903
Practice Address - Fax:503-747-3365
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-08-23
Last Update Date:2023-08-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage TherapistGroup - Multi-Specialty
No171100000XOther Service ProvidersAcupuncturistGroup - Multi-Specialty